NPIMap

Organization Active NPI

McKenzie Healthcare, LLC

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Louisa, KY
National Provider Identifier
1396873501
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
License
90050642 Issued in KY
Legal business name
MCKENZIE HEALTHCARE, LLC
Doing business as
J J Jordan Geriatric Center
Practice address
270 E Clayton LN
Louisa, KY 41230-8622
Phone
(606) 638-4170
Fax
(606) 638-0367
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David B. McKenzie, MBA, CPA
Title
Administrator
Phone
(606) 638-4170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 90050642 KY Primary

Addresses

Primary practice location

270 E Clayton LN
Louisa, KY 41230-8622

Mailing address

270 E Clayton LN
Louisa, KY 41230-8622
Phone (606) 638-4170

Other identifiers 1

IdentifierTypeStateIssuer
90050642MedicaidKY

Other names 1

  • J J Jordan Geriatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
J J Jordan Geriatric Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396873501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E CLAYTON LN",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412308622",
            "telephone_number": "606-638-4170",
            "fax_number": "606-638-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E CLAYTON LN",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412308622",
            "telephone_number": "606-638-4170",
            "fax_number": "606-638-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "606-638-4170",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "KY",
            "license": "90050642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90050642",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J J Jordan Geriatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisa, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.