Individual provider Active NPI

Vanessa McKenzie, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1952332595
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25678 Issued in TN
Practice address
1200 E Raines Rd Ste 101
Memphis, TN 38116-5829
Phone
(866) 364-8944
Fax
(877) 319-1936
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A45867 CA
Internal Medicine Physician 207R00000X 25678 TN Primary
Internal Medicine Physician 207R00000X 17796 MS

Addresses

Primary practice location

1200 E Raines Rd Ste 101
Memphis, TN 38116-5829

Mailing address

1200 E Raines Rd Ste 101
Memphis, TN 38116-5829
Phone (866) 364-8944

Other identifiers 5

IdentifierTypeStateIssuer
3093293MedicaidTN
00126757MedicaidMS
110108905OtherTNRAILROAD MEDICARE
5001948OtherTNTLC
3031027OtherTNBLUE CROSS BLUE SHIELD TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111221000542 TN Practitioner - Internal MedicinePractitioner - Family Practice 2668411844 Reassigns benefits to 1 organization
I20130305000483 CA Practitioner - Internal Medicine 2668411844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
University of Nebraska College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanitas Medical Center of Tennessee PCGroup PAC ID 5193143287, 13 clinicians

Practice addresses (Care Compare)

1200 E Raines Rd
Suite 101
Memphis, TN 38116-5829
Phone (786) 408-8502

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17796MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meharry Health Network, PC CurrentSince Jan 30, 2023 Accepting new patients
Methodist Healthcare Community Care Associates Current Accepting new patients
Baldwin Hills Crenshaw Urgent Care CurrentSince Jun 16, 2016 Accepting new patients
Adult Primary Care of Memphis PC Internal Medicine Past Accepting new patients
DRH Medical Group Past Accepting new patients

Locations

3650 W Martin Luther King Jr Blvd
Ste 185
Los Angeles, CA 90008
Phone (323) 294-4266

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035

438 N Cleveland St
Memphis, TN 38104
Phone (866) 364-8944

1200 E Raines Rd
Ste 101
Memphis, TN 38116
Phone (663) 648-9448

8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001

Interoperability endpoints

  • Direct secure messaging: vanessa.mckenzie@wwmp.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1952332595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E RAINES RD STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381165829",
            "telephone_number": "866-364-8944",
            "fax_number": "877-319-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E RAINES RD STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381165829",
            "telephone_number": "866-364-8944",
            "fax_number": "877-319-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "VANESSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A45867",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "25678",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "17796",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093293",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126757",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110108905",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "5001948",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "3031027",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.