Individual provider Active NPI

McKenzie Elle Wylie, DO

  • Family Medicine Physician
  • Ozark, MO
National Provider Identifier
1568956670
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021010687 Issued in MO
Practice address
5100 N Towne Centre Dr
Ozark, MO 65721-7479
Phone
(417) 269-2215
Fax
(417) 269-2427
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021010687 MO Primary

Addresses

Primary practice location

5100 N Towne Centre Dr
Ozark, MO 65721-7479

Mailing address

PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 730-6430

Other names 1

  • Dr. McKenzie Elle Wylie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210820001843 MO Practitioner - Family Practice 7911302476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

5100 N Towne Centre Dr
Ozark, MO 65721-7479
Phone (417) 269-2215

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021010687MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Family Medicine CurrentSince Aug 30, 2021 Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince Aug 30, 2021 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients

Locations

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

1530 E Republic Rd
Springfield, MO 65804
Phone (417) 269-1362

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1568956670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N TOWNE CENTRE DR",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657217479",
            "telephone_number": "417-269-2215",
            "fax_number": "417-269-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "MCKENZIE",
        "middle_name": "ELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021010687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "WYLIE",
            "middle_name": "ELLE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ozark, MO

Sources for this page

Verify at the official NPI Registry.