Individual provider Active NPI

Mackenzie Lynn Williams, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1629581764
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007637 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Nov 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95007637 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (800) 926-8273

Other practice location 1

1010 W La Veta Ave Ste 755
Orange, CA 92868-4306
Phone (714) 543-8911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200713002227 CA Practitioner - Nurse Practitioner 0345663134 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians

Practice addresses (Care Compare)

10538 Mission Gorge Rd
Suite 100
Santee, CA 92071-3154
Phone (619) 456-0033

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jul 9, 2020 Accepting new patients
Somagen Healthcare Inc CurrentSince Mar 1, 2023 Accepting new patients
Regents of the University of California CurrentSince Apr 12, 2022 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince Apr 12, 2022 Accepting new patients
Regents of the University of California Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jul 9, 2020 Accepting new patients
Somagen Healthcare Inc CurrentSince Mar 1, 2023 Accepting new patients
Golden State Emergency Physicians Inc CurrentSince Jan 4, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
UC San Diego Health Community Group CurrentSince Apr 12, 2022 Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
James E. Pierog, MD, Inc. Past Accepting new patients

Locations

760 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 821-2300

750 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 259-9462

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

1740 Rosecrans St
San Diego, CA 92106
Phone (619) 790-7800

8260 Mira Mesa Blvd
Ste A
San Diego, CA 92126
Phone (855) 362-9773

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

8590 Rio San Diego Dr
Ste 111
San Diego, CA 92108
Phone (619) 736-4600

4725 Market St
San Diego, CA 92102
Phone (619) 515-2560

5671 Balboa Ave
San Diego, CA 92111
Phone (855) 362-9773

Organizations & group practices 12

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": "1510358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1629581764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 W La Veta Ave Ste 755",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684306",
            "country_code": "US",
            "telephone_number": "714-543-8911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MACKENZIE",
        "middle_name": "LYNN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.