Individual provider Active NPI

McKenzie White

  • Physician Assistant
  • Salem, VA
National Provider Identifier
1609518646
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1930 Braeburn Cir
Salem, VA 24153-7388
Phone
(540) 444-8100
NPI assigned
Apr 11, 2022
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1930 Braeburn Cir
Salem, VA 24153-7388

Mailing address

300 Monticello Ave
Lynchburg, VA 24501-5616

Other practice location 1

300 Monticello Ave
Lynchburg, VA 24501-5616
Phone (434) 544-8876

Other names 1

  • McKenzie Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215002231 VA Practitioner - Physician Assistant 3870962749

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.67 of 100Reported as group
Quality
66.8
Promoting interoperability
100
Improvement activities
40
Cost
75.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mckenzie.harris@hca6.eclinicaldirectplus.com
  • Direct secure messaging: mckenzie.white.1@30160.direct.athenahealth.com

Hospital & facility affiliations 1

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1609518646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MONTICELLO AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245015616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BRAEBURN CIR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537388",
            "telephone_number": "540-444-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Monticello Ave",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245015616",
            "country_code": "US",
            "telephone_number": "434-544-8876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "HARRIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.