Patricia Flynn McKenzie, B.C, A.N.P.

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

143563 Issued in MO

Practice address

915 N Grand Blvd
Primary Care Service Line
Saint Louis, MO 63106-1621

Phone

(314) 652-4100

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• West County Pulmonary Associates

  • Pulmonary Disease Physician
  • Kirkwood, MO
  • NPI 1134248412
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184457600000",
    "number": "1861538654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16134 BARRIER REEF CT",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401815",
            "telephone_number": "636-527-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "address_2": "PRIMARY CARE SERVICE LINE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "PATRICIA",
        "middle_name": "FLYNN",
        "name_prefix": "Mrs.",
        "credential": "B.C, A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "143563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428744205",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian T McKenna, M.D.
• Melissa L McKenna, LPC
• Clark R McKenzie, MD
• Kerry Alicia McKenzie, NURSE PRACTITIONER
• Laura Beth McKenzie, DO
• Phoelica McKenzie, LCSW
• Eileen F. McKeon, ANP
• Erin McKeon, FNP-C
• Edward Cole McKeown, DPT
• Clayton Edward McKiddy, ANP

• Primary Care Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.