Gwenn Marie McKenzie, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD.18931 Issued in AL

Practice address

2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235

Phone

(205) 758-6647

Fax

(205) 750-2154

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Whatley Health Services IncGroup PAC ID 8224921705, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Whatley Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Tuscaloosa, AL
  • NPI 1063422756
  Medicare reassignment Care Compare group NPD
• Whatley Health Services, Inc.

  • Community/Retail Pharmacy
  • Tuscaloosa, AL
  • NPI 1477276749
  NPD

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1851989610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 SHAMLEY DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062917",
            "telephone_number": "205-292-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 MARTIN LUTHER KING BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354015235",
            "telephone_number": "205-758-6647",
            "fax_number": "205-750-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "GWENN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "18931",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.18931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren McGuffey, CRNP
• Stephanie K McHenry, CRNA
• Shelley McIntire, PHARMD
• Alissa Carolina McIntyre, MA
• Brian Gordon McKaig, CRNA
• Rick L McKenzie, MD
• William K McKibbin, M.D.
• Jeremy R. McKinney, D.M.D., M.D.S.
• Robert Earl McKinney, L.C.S.W.
• John Marvin McKissick, KINESIOTHERAPIST

• Internal Medicine Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.