Nancy J McKenzie, PA
Individual provider Active NPI Physician Assistant · Eureka, KS
NPI 1891780086 · NPPES record last updated Jun 26, 2012
Key facts
- NPI
- 1891780086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- KS148 (KS)
- Practice address
- 110 E 16TH St
Eureka, KS 67045-1067 - Phone
- (620) 583-7451
- Fax
- (620) 583-6702
- NPI assigned
- Sep 14, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Greenwood County Hospital
Practice addresses (Care Compare)
100 W 16TH St
Eureka, KS 67045-1064
Phone (620) 583-5274
Hospital & facility affiliations
- Greenwood County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040921000484 | KS | Practitioner - Physician Assistant | 7012985724 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS148 | KS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenwood County Hospital | Current |
Accepting new patients | |
| Greenwood County Hospital | Past | Accepting new patients |
Locations
100 W 16th St
Eureka, KS 67045
Phone (620) 583-5274
Interoperability endpoints
- nancy.mckenzie.1@12044.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | KS148 | KS | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100352110C | Medicaid | KS | |
| 178960 | Other | RURAL HEALTH MEDICARE | |
| 100428860A | Other | GROUP MEDICAID |
Other providers in Eureka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.