McKenzie Medical Center PC

Organization Active NPI Clinic/Center · MC Kenzie, TN

NPI 1700534229 · NPPES record last updated Mar 31, 2025

Key facts

NPI
1700534229
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
MCKENZIE MEDICAL CENTER PC
Practice address
205A Hospital Dr
MC Kenzie, TN 38201-1649
Phone
(731) 352-7907
Fax
(833) 690-3848
NPI assigned
Mar 14, 2022
Organization subpart
No

Authorized official

Name
Tammy Etheridge
Title
Chief Operating Officer
Phone
(731) 352-7907

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040619000083 TN Part B Supplier - Clinic/Group Practice 2365427853 Receives reassigned benefits from 34 practitioners
7 other NPIs on this enrollment
Practice locations: Trenton, TN; McKenzie, TN; MC Kenzie, TN; Huntingdon, TN; Gleason, TN; Dresden, TN; Camden, TN; Bruceton, TN…

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

205A Hospital Dr
MC Kenzie, TN 38201-1649

Mailing address

205A Hospital Dr
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other names

  • Hometown Health Clinic Doing business as

Other providers in MC Kenzie, TN

All providers in MC Kenzie, TN · Clinic/Center in Tennessee

Sources for this page

Verify at the official NPI Registry.