Stacey W McKenzie, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

18756 Issued in TN

Practice address

2151 Century LN
Johnson City, TN 37604-4469

Phone

(423) 926-2500

Fax

(423) 926-5999

NPI assigned

Aug 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Infectious Diseases Consultants & Travel Medicine

  • Infectious Disease Physician
  • Charleston, SC
  • NPI 1073592937
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1699768101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70403",
            "address_2": "365 STOUT DRIVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141703",
            "telephone_number": "423-439-4515",
            "fax_number": "423-439-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 CENTURY LN",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044469",
            "telephone_number": "423-926-2500",
            "fax_number": "423-926-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "STACEY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "18756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q010241",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark B McHaney, MD
• Mendi A McHone, BS
• Laura May McInnis, LPC
• Shelly J McIntosh, FNP
• Scyron R McInturff, APRN, PMHNP-BC
• Tamra Suzanne McKenzie, MD
• Bart Isaac McKinney, MD
• Cathy Louise McKinney, RN
• Jason Dewayne McKinney, D.O.
• Mariah Lynn McKinney, PHARMD

• Infectious Disease Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Infectious Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.