Tracey Cora McKenzie, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

415048-1 Issued in NY

Practice address

17 Bank Ave
Smithtown, NY 11787-2703

Phone

(631) 265-5300

NPI assigned

Nov 4, 2015

Last updated

Aug 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Christian Nursing Registry, Inc.

  • Home Health Agency
  • Smithtown, NY
  • NPI 1912038274
  NPD

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1972976520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FAIRFIELD WAY APT 14",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253417",
            "telephone_number": "631-889-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BANK AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872703",
            "telephone_number": "631-265-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "TRACEY",
        "middle_name": "CORA",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "415048-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlynn Christine McGlone, L. AC
• Paul T McGovern, PA
• Anne Marie McGrath, ANP
• Meghan Rehm McGrath, LMSW
• Kate McHugh
• Ann Marie M McKuhan, CF-SLP
• Regina Marie McLean, MS PT
• Patricia L McMahon, RN
• Connor McMurray, DPT
• Kimberly McNicholl, AUD

• Registered Nurse in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.