Individual provider Active NPI

Mary Keen, DPH

  • Ambulatory Care Pharmacist
  • McKenzie, TN
National Provider Identifier
1861363616
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
46793 Issued in TN
Practice address
15385 Highland Dr
MC Kenzie, TN 38201-2501
Phone
(731) 352-0820
NPI assigned
Sep 15, 2025
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 46793 TN Primary

Addresses

Primary practice location

15385 Highland Dr
MC Kenzie, TN 38201-2501

Mailing address

15385 Highland Dr
MC Kenzie, TN 38201-2501
Phone (731) 352-0820

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

State licenses

LicenseStateTypeSpecialty
46793TNMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1861363616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15385 HIGHLAND DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382012501",
            "telephone_number": "731-352-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15385 HIGHLAND DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382012501",
            "telephone_number": "731-352-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "MARY",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "TN",
            "license": "46793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 15, 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.

Verify at the official NPI Registry.