Individual provider Active NPI

Brittani McKenzie

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1376147041
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
029014 Issued in GA
Practice address
2429 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1713
Phone
(404) 691-3344
Fax
(404) 691-7205
NPI assigned
Nov 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 029014 GA Primary

Addresses

Primary practice location

2429 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1713

Mailing address

2429 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1713
Phone (404) 691-3344

Other identifiers 1

IdentifierTypeStateIssuer
0006802048MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL cvshealth Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
029014GAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1376147041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111713",
            "telephone_number": "404-691-3344",
            "fax_number": "404-691-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111713",
            "telephone_number": "404-691-3344",
            "fax_number": "404-691-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "BRITTANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "029014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006802048",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cvshealth",
            "affiliation": "N",
            "endpointDescription": "cvshealth",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2429 Martin Luther King Jr Dr SW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303111713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.