Mackenzie S Warrick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

53880 Carmichael Dr
South Bend, IN 46635-1567

Phone

(574) 247-9441

Fax

(574) 247-9442

NPI assigned

Oct 3, 2019

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

Other names 1

• Mackenzie S Redman Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: mackenzie.warrick.1@13070.direct.athenahealth.com
• Direct secure messaging: mackenzie.warrick.1@18573.direct.athenahealth.com

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.

• Honor Physicians, LLC

  • Primary Care Clinic/Center
  • Mishawaka, IN
  • NPI 1194288860
  Medicare reassignment

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1730720301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60160 Bodnar Blvd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465449338",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARRICK",
        "first_name": "MACKENZIE",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA MEDICAL LICENSE",
            "identifier": "10002823A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.sbortho.com",
            "affiliation": "N",
            "endpointDescription": "Practice web address",
            "address_1": "53880 Carmichael Dr",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466351567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "REDMAN",
            "middle_name": "S",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard J. Ward, MD
• Patrick Warmoth, STUDENT
• Gerald Warrell, D.D.S.
• Terryanah Aneice Warren
• William James Warrender, M.D.
• Jordan Warth, MS, NCC, LMHCA
• Thomas B Was, LMHC
• Barbara A Wascisin Hernly, LSW
• Cassandra Washington
• Jerica Washington, RBT

• Physician Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.