McKenzie Grace Holbrook

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

166121 Issued in KY

Practice address

554 Bentley Loop
Jenkins, KY 41537-9005

Phone

(859) 779-8802

NPI assigned

Aug 23, 2017

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech Matters

  • Early Intervention Provider Agency
  • Jenkins, KY
  • NPI 1043082100
  NPD Authorized official

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1861919730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 BENTLEY LOOP",
            "city": "JENKINS",
            "state": "KY",
            "postal_code": "415379005",
            "telephone_number": "859-779-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 BENTLEY LOOP",
            "city": "JENKINS",
            "state": "KY",
            "postal_code": "415379005",
            "telephone_number": "859-779-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "MCKENZIE",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008703",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "166121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Lynn Fleming, APRN
• Melissa Ann Fleming, MS CCC-SLP
• Graham Apothecary, Inc (Boggs Pharmacy)
• Jay Timothy Graham
• James Eric Hicks, PHARMD
• Jenkins Family Clinic, LLC
• Jenkins Family Clinic, LLC
• Jenkins Healthcare Company (Jenkins Community Hospital)
• Jenkins Healthcare Company Bda Jenkins Community Hospital
• Jenkins Healthcare Company Inc

• Speech-Language Pathologist in Jenkins, KY
• Providers in Jenkins, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.