Katelyn Roe McKenzie, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-169361 Issued in AL

Practice address

1470 Taylor Rd Ste 109
Montgomery, AL 36117-3747

Phone

(334) 530-6361

NPI assigned

Dec 4, 2020

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 AL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Children's Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Birmingham, AL
  • NPI 1124541438
  Medicare reassignment NPD
• Charles Henderson Memorial Association

  dba Charles Henderson Child Health Center

  • Clinic/Center
  • Troy, AL
  • NPI 1346207131
  NPD (past)
• Urgent Care for Children, PLLC

  • Pediatrics Physician
  • Hixson, TN
  • NPI 1205434420
  NPD (past)

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1467058529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 TAYLOR RD STE 109",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173747",
            "telephone_number": "334-530-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 TAYLOR RD STE 109",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173747",
            "telephone_number": "334-530-6361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331802",
            "country_code": "US",
            "telephone_number": "205-934-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "KATELYN",
        "middle_name": "ROE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-169361",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-169361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ann McIntyre, RN
• Julian Edward McIntyre, MD
• Patrick R McIntyre, CRNP
• Agnes Kathleen McKeen, LPC
• Amber Alexandria McKenzie
• Veronica McKenzie, RN
• Rebecca Carli McKinley, MA, CCC-SLP
• Gabrielle Mariana McKinney
• Keyana Marie McKinney
• Porscha Danielle McKinnie, RBT

• Pediatric Nurse Practitioner in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.