Individual provider Active NPI

McKenzie Stieneker

  • Pediatric Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1619337920
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3010168 Issued in KY
Practice address
1000 Breckenridge St Ste 301
Owensboro, KY 42303-0877
Phone
(502) 588-7450
Fax
(502) 588-7728
NPI assigned
Feb 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3010168 KY Primary

Addresses

Primary practice location

1000 Breckenridge St Ste 301
Owensboro, KY 42303-0877

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20241218000359 KY Practitioner - Nurse Practitioner 8123555927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3010168KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children'S Medical Group, LLC CurrentSince Feb 1, 2025 Accepting new patients
Norton Children'S Medical Group, LLC Pediatrics Current Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Feb 1, 2025 Accepting new patients
Owensboro Pediatrics LLC Pediatrics Past Accepting new patients

Locations

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

1000 Breckenridge St
Ste 301
Owensboro, KY 42303
Phone (270) 852-8894

Interoperability endpoints

  • Direct secure messaging: mmattingly62191@direct.owensborohealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1619337920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRECKENRIDGE ST STE 301",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423030877",
            "telephone_number": "502-588-7450",
            "fax_number": "502-588-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIENEKER",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3010168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.