Mackenzie Johnson, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN11018063 Issued in FL

Practice address

1812 Health Care Dr
Trinity, FL 34655-5362

Phone

(813) 731-0944

NPI assigned

Feb 10, 2022

Last updated

Mar 11, 2022By the provider in NPPES

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 names 1

• Mackenzie Evans Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Trinity, FL
  • NPI 1861168643
  NPD
• Pediatric Health Care Alliance

  • Registered Nurse
  • Odessa, FL
  • NPI 1801728738
  NPD (past)
• Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Oldsmar, FL
  • NPI 1609965441
  NPD (past)

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1710631544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11632 CROWNED SPARROW LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 HEALTH CARE DR",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555362",
            "telephone_number": "813-731-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MACKENZIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11018063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "EVANS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Joe
• Enola Daphne Rieta Joefield, M.A.
• Benston Daniel Johnson, DO
• Brian T Johnson, MD PL
• Dana Johnson, PHD, MS, OTR/L
• Victor Alexander Jolly, MD
• Brant Michael Jones
• Jess Jones
• Kiera Jones
• Ramu Srinivas Jonnalagadda, M.D.

• Pediatric Nurse Practitioner in Trinity, FL
• Providers in Trinity, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.