Individual provider Active NPI

Nancy J McKenzie, PA

  • Physician Assistant
  • Eureka, KS
National Provider Identifier
1891780086
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
KS148 Issued in KS
Practice address
110 E 16TH St
Eureka, KS 67045-1067
Phone
(620) 583-7451
Fax
(620) 583-6702
NPI assigned
Sep 14, 2005
Last updated
Jun 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X KS148 KS Primary

Addresses

Primary practice location

110 E 16TH St
Eureka, KS 67045-1067

Mailing address

110 E 16TH St
Eureka, KS 67045-1067
Phone (620) 583-7451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20040921000484 KS Practitioner - Physician Assistant 7012985724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenwood County HospitalGroup PAC ID 0042129603, 31 clinicians

Practice addresses (Care Compare)

100 W 16TH St
Eureka, KS 67045-1064
Phone (620) 583-5274

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
KS148KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood County Hospital CurrentSince Jan 1, 1987 Accepting new patients
Greenwood County Hospital CurrentSince Jan 1, 1987 Accepting new patients
Greenwood County Hospital Past Accepting new patients

Locations

100 W 16th St
Eureka, KS 67045
Phone (620) 583-5274

110 E 16th St
Eureka, KS 67045
Phone (620) 583-7451

Interoperability endpoints

  • Direct secure messaging: nancy.mckenzie.1@12044.direct.athenahealth.com

Organizations & group practices 4

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.

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1891780086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 16TH ST",
            "city": "EUREKA",
            "state": "KS",
            "postal_code": "670451067",
            "telephone_number": "620-583-7451",
            "fax_number": "620-583-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 16TH ST",
            "city": "EUREKA",
            "state": "KS",
            "postal_code": "670451067",
            "telephone_number": "620-583-7451",
            "fax_number": "620-583-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "KS148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, KS

Sources for this page

Verify at the official NPI Registry.