Individual provider Active NPI

Mackenzie Renee Frazier, OT

  • Occupational Therapist
  • Frederick, MD
National Provider Identifier
1417469883
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
08300 Issued in MD
Practice address
86 Thomas Johnson CT
Frederick, MD 21702-4348
Phone
(301) 694-8311
Fax
(301) 694-3537
NPI assigned
Oct 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 08300 MD Primary

Addresses

Primary practice location

86 Thomas Johnson CT
Frederick, MD 21702-4348

Mailing address

3131 Hawks Hill LN
Keedysville, MD 21756-1813
Phone (240) 818-7153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180313000361 MD Practitioner - Occupational Therapist in Private Practice 6406118322 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08300MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Leadbetter Rehabilitation, LLC Occupational Therapist CurrentSince Nov 8, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Leadbetter Rehabilitation, LLC Occupational Therapist CurrentSince Aug 10, 2020 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Feb 6, 2018 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Feb 6, 2018 Accepting new patients

Locations

8420 Gas House Pike
Ste U
Frederick, MD 21701
Phone (240) 559-2624

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1417469883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 HAWKS HILL LN",
            "city": "KEEDYSVILLE",
            "state": "MD",
            "postal_code": "217561813",
            "telephone_number": "240-818-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 THOMAS JOHNSON CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024348",
            "telephone_number": "301-694-8311",
            "fax_number": "301-694-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "MACKENZIE",
        "middle_name": "RENEE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "08300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.