Individual provider Active NPI

McKenzie White, MD

  • Surgery Physician
  • Saint Paul, MN
National Provider Identifier
1518454594
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
69929 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 495-6600
Fax
(651) 254-3123
NPI assigned
Apr 16, 2018
Last updated
Nov 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 69929 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

420 Delaware St SE Ste 195
Minneapolis, MN 55455-2202
Phone (612) 625-6483

Other names 1

  • McKenzie Akers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228001807 MN Practitioner - General Surgery 8123379278 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Oct 28, 2022 Accepting new patients
Group Health, Inc. CurrentSince Dec 9, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince Oct 28, 2022 Accepting new patients
Fairview Express Care CurrentSince Oct 28, 2022 Accepting new patients
Fairview Clinics CurrentSince Oct 28, 2022 Accepting new patients
Group Health, Inc. CurrentSince Dec 9, 2021 Accepting new patients
Fairview Health Services CurrentSince Oct 28, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Oct 28, 2022 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

420 Delaware St SE
Ste 195
Minneapolis, MN 55455
Phone (612) 301-9433

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

15290 Pennock Ln
Saint Paul, MN 55124
Phone (952) 431-8500

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1518454594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-495-6600",
            "fax_number": "651-254-3123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE Ste 195",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554552202",
            "country_code": "US",
            "telephone_number": "612-625-6483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MCKENZIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "69929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "AKERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.