Individual provider Active NPI

Mackenzie Alyse Polochak, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Morristown, TN
National Provider Identifier
1861375008
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
39071 Issued in TN
Practice address
1530 W Andrew Johnson Hwy
Morristown, TN 37814-3733
Phone
(423) 507-8951
NPI assigned
Jul 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 39071 TN Primary

Addresses

Primary practice location

1530 W Andrew Johnson Hwy
Morristown, TN 37814-3733

Mailing address

639 Richland Creek Dr
Blaine, TN 37709-5441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922002093 TN Practitioner - Nurse Practitioner 7214431287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Center PLLCGroup PAC ID 9739253022, 2 clinicians

Practice addresses (Care Compare)

1530 W Andrew Johnson Hwy
Morristown, TN 37814-3733
Phone (423) 307-8951

Hospital & facility affiliations

  • Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
39071TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Center PLLC CurrentSince Sep 15, 2025 Accepting new patients
Pulmacare Inc PastSince Aug 3, 2025 Accepting new patients

Locations

1530 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 307-8951

Organizations & group practices 2

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": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1861375008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 RICHLAND CREEK DR",
            "city": "BLAINE",
            "state": "TN",
            "postal_code": "377095441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 W ANDREW JOHNSON HWY",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143733",
            "telephone_number": "423-507-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLOCHAK",
        "first_name": "MACKENZIE",
        "middle_name": "ALYSE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "39071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.