McKenzie Smith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202002098NP-PP Issued in OR

Practice address

121 NE a St
Grants Pass, OR 97526-2111

Phone

(541) 835-8435

Fax

(541) 314-9617

NPI assigned

Jul 12, 2016

Last updated

Mar 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Functional Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Winston, OR
  • NPI 1154944536
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1932551165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NE A ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262111",
            "telephone_number": "541-326-8078",
            "fax_number": "541-314-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 NE A ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262111",
            "telephone_number": "541-835-8435",
            "fax_number": "541-314-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202002098NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMHNP",
            "identifier": "1932551165",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kianne Rachelle Smith, CRNA
• Kimberly Kristi Smith, APRN-NP
• Letty Smith
• Lori Elizabeth Smith, LPTA WCC
• Lori Lynn Smith
• Phyllis Biergie Smith, RN, BSN
• Roger James Smith, DMD
• Shawn Smith
• Sydney Noelle Smith, RN
• Timothy Alan Smith, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.