Individual provider Active NPI

Hugh Urie Mackenzie IV, FNP

  • Family Nurse Practitioner
  • Crystal Cty, MO
National Provider Identifier
1972440105
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2026028092 Issued in MO
Practice address
1400 US Highway 61
Crystal Cty, MO 63028-4100
Phone
(636) 933-1111
NPI assigned
May 4, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2026028092 MO Primary

Addresses

Primary practice location

1400 US Highway 61
Crystal Cty, MO 63028-4100

Mailing address

4322 Lockeport LNDG
Hillsboro, MO 63050-3629
Phone (636) 208-7212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
260023MOMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1972440105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4322 LOCKEPORT LNDG",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630503629",
            "telephone_number": "636-208-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "CRYSTAL CTY",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "HUGH",
        "middle_name": "URIE",
        "name_suffix": "IV",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2026028092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Cty, MO

Sources for this page

Verify at the official NPI Registry.