Mackenzie Emma Mitchell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14686 Issued in WI

Practice address

26425 Lakeland Ave S
Webster, WI 54893-8343

Phone

(715) 866-4271

Fax

(715) 866-4284

NPI assigned

May 23, 2019

Last updated

May 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgauger406743@excellian.direct.allina.com

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.

• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922

  Physical Therapist

  Medicare reassignment NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1538726674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26425 LAKELAND AVE S",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548938343",
            "telephone_number": "715-866-4271",
            "fax_number": "715-866-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MACKENZIE",
        "middle_name": "EMMA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Andrew McKinley, D.D.S.
• Tania M McKnight, RDH
• Jennifer L McNamara, MA, CSAC
• Susan Evelyn Merchant
• Holly Mishler-Johnson, REGISTERED NURSE
• Muskadee Linda Montano, MSW, APSW
• Pamela Jo Nichols, R.N.
• Lona Marie Noll, LPN
• Northwest Passage LTD
• Northwest Passage Services Inc

• Physical Therapist in Webster, WI
• Providers in Webster, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.