Makaria Kenzie McMullen, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2026005553 Issued in MO

Practice address

1390 US Highway 61 Ste N1500
Crystal Cty, MO 63028-4137

Phone

(636) 933-8050

Fax

(636) 933-8047

NPI assigned

Nov 3, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Surgical Specialists, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1043530538
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1396614996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61 STE N1500",
            "city": "CRYSTAL CTY",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-8050",
            "fax_number": "636-933-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61 STE N1500",
            "city": "CRYSTAL CTY",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-8050",
            "fax_number": "636-933-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MAKARIA",
        "middle_name": "KENZIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020027835",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2026005553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorgis Ignacio Jimenez Perez, MD
• Alexandra Bahar Khodadadi, MD, MSPH
• Brandy Michelle Koch, FNP
• Kortni Lampe, PHARMD
• Hugh Urie Mackenzie IV, FNP
• Kyungjun Min, PT, DPT, CSCS
• Jordyne Payne, FNP-BC
• Halie Rianne Scheffler, MSN-FNP
• Richard Martin Silverman, MD
• Mackenzie Taychert, DO

• Family Nurse Practitioner in Crystal Cty, MO
• Providers in Crystal Cty, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.