Active NPI
Andrew McKenzie, MD, PHD
- Psychiatry Physician
- Salem, OR
National Provider Identifier
1962067108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD217479
- Practice address
- 3265 Marietta St SE
Salem, OR 97317-9402 - Phone
- (503) 583-8367
- NPI assigned
- May 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD217479 | OR | Primary |
Addresses
Primary practice location
3265 Marietta St SE
Salem, OR 97317-9402
Mailing address
3265 Marietta St SE
Salem, OR 97317-9402
Phone (503) 583-8367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD217479 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1962067108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3265 MARIETTA ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973179402",
"telephone_number": "503-583-8367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3265 MARIETTA ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973179402",
"telephone_number": "503-583-8367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "ANDREW",
"credential": "MD, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-02",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD217479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.