Alan Roger Mackenzie, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5045 Issued in SC

Practice address

3300 4TH Ave
Conway, SC 29527-6002

Phone

(843) 248-5728

NPI assigned

May 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467663534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 HIGHWAY 17 S # 160",
            "address_2": "216 14 TH AVE S",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756040",
            "telephone_number": "843-650-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 4TH AVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295276002",
            "telephone_number": "843-248-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "ALAN",
        "middle_name": "ROGER",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyons Prosthetics & Orthotics, Inc.
• Alexander L Lyons, CPO
• M&M Mitchell Inc. (Perspectives Counseling)
• Molly Ann Mabry, PA-C
• Aimar P Mack, MD
• Adrian Madrid, DO
• Siobhan Maerz, LMSW
• Michael F. Magill
• Magnolia Pediatrics
• Jessica Lynn Mahady, AGACNP-BC

• Physical Therapist in Conway, SC
• Providers in Conway, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.