Individual provider Active NPI

Steven McKenzy, PH.D

  • Specialist
  • Fort Meade, FL
National Provider Identifier
1710024526
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA 37847 Issued in FL
Practice address
304 N Charleston Ave
Fort Meade, FL 33841-2403
Phone
(863) 448-7476
NPI assigned
Jan 31, 2007
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA 37847 FL Primary

Addresses

Primary practice location

304 N Charleston Ave
Fort Meade, FL 33841-2403

Mailing address

528 S Seminole Ave
Fort Meade, FL 33841-3448
Phone (863) 448-7476

Other identifiers 3

IdentifierTypeStateIssuer
6915027 96MedicaidFL
6915027 03MedicaidFL
6915027 98MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

528 S Seminole Ave
Fort Meade, FL 33841-3448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MA 37847FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gye Nyame Wellness Centre Current Accepting new patients
Gye Nyame Wellness Centre, LLC Current Accepting new patients

Locations

304 N Charleston Ave
Fort Meade, FL 33841
Phone (863) 448-7476

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1710024526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 S SEMINOLE AVE",
            "city": "FORT MEADE",
            "state": "FL",
            "postal_code": "338413448",
            "telephone_number": "863-448-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N CHARLESTON AVE",
            "city": "FORT MEADE",
            "state": "FL",
            "postal_code": "338412403",
            "telephone_number": "863-448-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZY",
        "first_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA 37847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6915027  96",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6915027 03",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6915027 98",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Meade, FL

Sources for this page

Verify at the official NPI Registry.