Individual provider Active NPI

McKenzie Lynn Banks

  • Family Nurse Practitioner
  • Kennesaw, GA
National Provider Identifier
1730776410
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN299977 Issued in GA
Practice address
3372 Verdi LN
Kennesaw, GA 30144-2600
Phone
(404) 969-6163
Fax
(747) 215-5464
NPI assigned
Dec 28, 2020
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN299977 GA Primary

Addresses

Primary practice location

3372 Verdi LN
Kennesaw, GA 30144-2600

Mailing address

3372 Verdi LN
Kennesaw, GA 30144-2600
Phone (336) 747-0685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250721002480 GA Practitioner - Nurse Practitioner 3375059926 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN299977GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CTD Network LLC CurrentSince Jul 11, 2025 Accepting new patients
Veritas Collaborative Georgia, LLC Past Accepting new patients

Locations

11605 Abercorn St
Savannah, GA 31419
Phone (615) 619-2585

Interoperability endpoints

  • Direct secure messaging: mckenzie.banks.1@31578.direct.athenahealth.com

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": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1730776410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3372 VERDI LN",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442600",
            "telephone_number": "336-747-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3372 VERDI LN",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442600",
            "telephone_number": "404-969-6163",
            "fax_number": "747-215-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "MCKENZIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN299977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.