Active NPI
Mackenzie King
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1821801283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 6006 Brandy Chase CV
Fort Wayne, IN 46815-7601 - Phone
- (260) 486-3001
- NPI assigned
- Jan 29, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
6006 Brandy Chase CV
Fort Wayne, IN 46815-7601
Mailing address
9505 Founders Way
Fort Wayne, IN 46835-9232
Phone (419) 296-0722
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1821801283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9505 FOUNDERS WAY",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359232",
"telephone_number": "419-296-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6006 BRANDY CHASE CV",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468157601",
"telephone_number": "260-486-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MACKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.