McKenzie Kori Jefferson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5021906 Issued in NC

Practice address

461 Western Blvd Ste 122
Jacksonville, NC 28546-7637

Phone

(910) 333-0283

Fax

(910) 333-0513

NPI assigned

Jun 27, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Star Medical Clinic PLLC 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Star Medical Clinic PLLC

  • General Practice Physician
  • Jacksonville, NC
  • NPI 1033565007

  NC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1730865320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WATERS LNDG",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547833",
            "telephone_number": "706-892-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 WESTERN BLVD STE 122",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467637",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "MCKENZIE",
        "middle_name": "KORI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarrod L. Gray, LPC, PC
• Nagesh H Jayaram, MD
• Jayds Home Care, LLC
• Jayds Transport LLC
• Shneighter Jean
• Irene Elizabeth Jenkins, COTA
• Perry Samuel Jenkins Jr., PMHNP-BC
• Susan B Jensen, DNP, CPNP-PC
• Taylor Jerosimich
• Ashley Jerread

• All providers in Jacksonville, NC
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.