Individual provider Active NPI

Mackenzie Hurley, CNP

  • Family Nurse Practitioner
  • Westerville, OH
National Provider Identifier
1922776764
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0032546 Issued in OH
Practice address
575 Copeland Mill Rd Ste 1D
Westerville, OH 43081-8977
Phone
(614) 794-0481
NPI assigned
Sep 4, 2021
Reactivated
Nov 9, 2022
Last updated
Jan 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0032546 OH Primary
Home Health Registered Nurse 163WH0200X RN.458445 OH

Addresses

Primary practice location

575 Copeland Mill Rd Ste 1D
Westerville, OH 43081-8977

Mailing address

PO Box 80
Zanesfield, OH 43360-0080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230222002100 OH Practitioner - Nurse Practitioner 1254704299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Colemans Xing
Suite B
Marysville, OH 43040-7115
Phone (937) 578-4310

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.458445OHMDHome Health Registered Nurse
APRN.CNP.0032546OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Union County CurrentSince Jan 1, 2023 Accepting new patients
Memorial Hospital of Union County CurrentSince Jan 1, 2023 Accepting new patients
Wedgewood Urgent Care, LTD CurrentSince Dec 15, 2022 Accepting new patients
Immediate Health Associates PastSince Jan 8, 2023 Accepting new patients

Locations

4460 Lake Forest Dr
Ste 216
Blue Ash, OH 45242
Phone (614) 234-0600

120 Colemans Crossing Blvd
Ste B
Marysville, OH 43040
Phone (937) 578-4310

1958 E US Highway 36
Urbana, OH 43078
Phone (937) 652-1834

575 Copeland Mill Rd
Ste 1D
Westerville, OH 43081
Phone (614) 794-0481

Interoperability endpoints

  • Direct secure messaging: mackenzie.hurley.1@31959.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": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1922776764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80",
            "city": "ZANESFIELD",
            "state": "OH",
            "postal_code": "433600080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 COPELAND MILL RD STE 1D",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818977",
            "telephone_number": "614-794-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "MACKENZIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "deactivation_date": "2022-10-21",
        "reactivation_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0032546",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN.458445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.