Individual provider Active NPI

Claudine McKenzie, ARNP

  • Primary Care Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1750779682
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP9189292 Issued in FL
Practice address
4101 NW 4TH St
Suite 200
Plantation, FL 33317-2850
Phone
(954) 791-5420
Fax
(954) 791-5950
NPI assigned
Dec 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP9189292 FL Primary
Family Nurse Practitioner 363LF0000X ARNP9189292 FL

Addresses

Primary practice location

4101 NW 4TH St
Suite 200
Plantation, FL 33317-2850

Mailing address

3977 NW 36TH Ter
Lauderdale Lakes, FL 33309-4803
Phone (954) 673-0013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9189292FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca a Prostko MD PA CurrentSince Mar 1, 2019 Accepting new patients

Locations

938 SW Martin Downs Blvd
Palm City, FL 34990
Phone (772) 221-7620

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1750779682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3977 NW 36TH TER",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094803",
            "telephone_number": "954-673-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 4TH ST",
            "address_2": "SUITE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172850",
            "telephone_number": "954-791-5420",
            "fax_number": "954-791-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "CLAUDINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9189292",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9189292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.