Active NPI
Kevin R McKenzie
- Behavior Analyst
- Edmond, OK
National Provider Identifier
1891010823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1717 W 33Rd St
Edmond, OK 73013-3819 - Phone
- (405) 216-5608
- NPI assigned
- Apr 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1717 W 33Rd St
Edmond, OK 73013-3819
Mailing address
524 SW 160 St
Oklahoma, OK 73170
Phone (405) 824-5589
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290470400000",
"number": "1891010823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 SW 160 ST",
"city": "OKLAHOMA",
"state": "OK",
"postal_code": "73170",
"telephone_number": "405-824-5589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 W 33RD ST",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133819",
"telephone_number": "405-216-5608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "KEVIN",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-01",
"last_updated": "2010-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.