Mackenzie Tully, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10012139 Issued in OR

Practice address

2825 E Barnett Rd
Medford, OR 97504-8332

Phone

(541) 789-7000

NPI assigned

Jul 20, 2023

Sex

Male

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 OR

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

Credentials

Nurse Practitioner

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.

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment NPD
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Medicare reassignment NPD
• Asante

  dba Heimann Cancer Center

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1538849831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4749",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "MACKENZIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10012139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammie Liu Tsuruoka, FNP-C
• Suzanne Margaret Tucker
• Blair John Tudor III, D.M.D.
• Tushar Anil Tuliani, MD
• Joy A Tully
• Nicole Marie Tuminaro, PA-C
• Lauren Tuosto, LPC
• Margareta Turceanu, RN
• Donald A Turcke, M.D.
• Joel Don Turgesen, LPC

• Family Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.