Individual provider Active NPI

Jennifer Roberts McKenzie, DPT

  • Physical Therapist
  • Montour Falls, NY
National Provider Identifier
1972713436
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023631-1 Issued in NY
Practice address
220 Steuben St
Montour Falls, NY 14865-9740
Phone
(607) 535-8616
Fax
(607) 210-1965
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 023631-1 NY Primary

Addresses

Primary practice location

220 Steuben St
Montour Falls, NY 14865-9740

Mailing address

220 Steuben St
Montour Falls, NY 14865-9740
Phone (607) 535-8616

Other practice location 1

11849 East Corning Road
Corning, NY 14830
Phone (607) 962-0102

Other practice location 2

11849 East Corning Road
Corning, NY 14830
Phone (607) 962-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171228000391 NY Practitioner - Physical Therapist in Private Practice 8022180017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023631-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler Hospital Inc CurrentSince Nov 1, 2017 Accepting new patients
Schuyler Hospital Inc CurrentSince Nov 1, 2017 Accepting new patients

Locations

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972713436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-535-8616",
            "fax_number": "607-210-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-535-8616",
            "fax_number": "607-210-1965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11849 East Corning Road",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "14830",
            "country_code": "US",
            "telephone_number": "607-962-0102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11849 East Corning Road",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "14830",
            "country_code": "US",
            "telephone_number": "607-962-0102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JENNIFER",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023631-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montour Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.