NPIMap

Organization Active NPI

McKenzie Medical Center

  • Urgent Care Clinic/Center
  • McKenzie, TN
National Provider Identifier
1841696192
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MCKENZIE MEDICAL CENTER
Practice address
205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Phone
(731) 352-7907
Fax
(731) 352-4459
NPI assigned
Nov 14, 2014
Last updated
Oct 24, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MCKENZIE MEDICAL CENTER, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Authorized official

Name
Lisa Kay Page
Title
Credentialing Manager
Phone
(731) 352-7907

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary
Physician Assistant 363A00000X PA1262 TN
Family Nurse Practitioner 363LF0000X APN6244 TN
Family Medicine Physician 207Q00000X MD23833 TN
Internal Medicine Physician 207R00000X MD15682 TN
Pediatrics Physician 208000000X MD46412 TN
Surgery Physician 208600000X MD45034 TN

Addresses

Primary practice location

205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649

Mailing address

205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other identifiers 2

IdentifierTypeStateIssuer
3380640OtherTNGROUP MEDICARE
3380640OtherTNGROUP MEDICAID

Other names 1

  • MMC URGENT CARE CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
McKenzie Medical Center10 organizations share this tax ID, including this one
Part of
McKenzie Medical Center

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1841696192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "SUITE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "SUITE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCKENZIE MEDICAL CENTER, PC",
        "enumeration_date": "2014-11-14",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "731-352-7907"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1262",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN6244",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD23833",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD15682",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD46412",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD45034",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "3380640",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "3380640",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMC URGENT CARE CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MMC URGENT CARE CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in McKenzie, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.