Individual provider Active NPI

Mackenzie McNamara

  • Certified Registered Nurse Anesthetist
  • Salem, VA
National Provider Identifier
1790483782
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024189369 Issued in VA
Practice address
1222 Roanoke Blvd
Salem, VA 24153-5204
Phone
(540) 355-9052
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001270228 VA
Certified Registered Nurse Anesthetist 367500000X 0024189369 VA Primary

Addresses

Primary practice location

1222 Roanoke Blvd
Salem, VA 24153-5204

Mailing address

1222 Roanoke Blvd
Salem, VA 24153-5204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240311002893 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981040128 Reassigns benefits to 2 organizations
I20250911000326 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981040128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acv IncGroup PAC ID 3870633936, 70 clinicians

Practice addresses (Care Compare)

5115 Bernard Dr
Suite 201
Roanoke, VA 24018-4367
Phone (540) 345-0289

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001270228VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jul 1, 2025 Accepting new patients
Acv Inc CurrentSince Feb 16, 2024 Accepting new patients
Anesthesiology Consultants of Virginia, Inc PastSince Feb 16, 2024 Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

5115 Bernard Dr
Ste 201
Roanoke, VA 24018
Phone (540) 345-0289

Organizations & group practices 3

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": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1790483782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535204",
            "telephone_number": "540-355-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAMARA",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001270228",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024189369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.