Individual provider Active NPI

Charles K Mackenzie, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1780698688
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-062825 Issued in AL
Practice address
911 Big Cove Rd SE
Anesthesia Dept
Huntsville, AL 35801-3750
Phone
(256) 265-8120
Fax
(256) 265-8969
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-062825 AL Primary

Addresses

Primary practice location

911 Big Cove Rd SE
Anesthesia Dept
Huntsville, AL 35801-3750

Mailing address

PO Box 1389
Huntsville, AL 35807-0389
Phone (205) 979-5882

Other identifiers 1

IdentifierTypeStateIssuer
51526815OtherALBCBS #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000918 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284688151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Hospital AnesthesiaGroup PAC ID 7315990751, 157 clinicians

Practice addresses (Care Compare)

245 Governors Dr SE
Huntsville, AL 35801-3784
Phone (256) 265-8120

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2005 Accepting new patients
The Health Care Authority of the City of Huntsville Past Accepting new patients

Locations

201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

911 Big Cove Rd SE
Huntsville, AL 35801
Phone (256) 265-8120

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780698688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1389",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358070389",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BIG COVE RD SE",
            "address_2": "ANESTHESIA DEPT",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013750",
            "telephone_number": "256-265-8120",
            "fax_number": "256-265-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "CHARLES",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-062825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "51526815",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.