MCKENZIE CLARK


Address: 51 Nassau St, Charleston, SC 29403-5513
Phone: 8437224112

MCKENZIE CLARK (NPI# 1528566932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528566932
Entity Type Individual
Full Name MCKENZIE CLARK
Practice Address 51 Nassau St
Charleston
SC 29403-5513
Mailing Address 157 Queen St Apt A
Charleston
SC 29401-2056
Practice Telephone 8437224112
Mailing Telephone 9417262825
Enumeration Date 2018-01-31
Last Update Date 2019-09-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
22661 SC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 51 NASSAU ST
City CHARLESTON
State SC
Zip Code 29403-5513

Providers in the same location

NPI Name Taxonomy Address Enumeration
1487604757 Charles Effiong Internal Medicine 51 Nassau St, Charleston, SC 29403-5513 2006-05-10
1679190771 Fetter Health Care Network, Inc Clinic/Center 51 Nassau St, Charleston, SC 29403-5513 2020-07-06
1902435316 Danielle Rivers Coles Pharmacist 51 Nassau St, Charleston, SC 29403-5513 2020-04-07
1700410461 Angela Maria Torres Ramirez Dietitian, Registered 51 Nassau St, Charleston, SC 29403-5513 2020-03-02
1073157749 Abdul Karim Kargbo Counselor 51 Nassau St, Charleston, SC 29403-5513 2019-11-05
1518514587 Irina Alexander Dental Hygienist 51 Nassau St, Charleston, SC 29403-5513 2019-08-23
1902460801 Victoria Danowski Dietitian, Registered 51 Nassau St, Charleston, SC 29403-5513 2019-04-25
1518433366 Lundy Davis Physician Assistant 51 Nassau St, Charleston, SC 29403-5513 2018-10-19
1194211243 Fetter Health Care Network, Inc. Clinic/Center 51 Nassau St, Charleston, SC 29403 2018-07-02
1710418033 Rina Mehta Pediatrics 51 Nassau St, Charleston, SC 29403-5513 2017-03-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780210674 Samantha Barretta Behavior Technician 530 Meeting St, Apt 409, Charleston, SC 29403 2020-03-23
1114497435 Publix Super Markets, Inc. Durable Medical Equipment & Medical Supplies 10 Westedge St, Suite 100, Charleston, SC 29403 2018-11-29
1194266072 Ashley Rogers Albrecht Dentist 29 Bee St, Fourth Floor, Charleston, SC 29403 2017-03-13
1427467307 Valerie Nicole Garilas Pharmacist 1400 Woodruff Road, Greenville, SC 29403 2014-08-05
1467883645 Disabilities Board of Charleston County Case Management 995 Morrison Drive, Suite 100, Charleston, SC 29403 2013-12-12
1326487588 Tracy Jon Tipton Urology 125 Doughty St Ste 300, Charleston, SC 29403 2013-06-21
1205171964 Brian Sherman Psychologist 26a Bee St., Charleston, SC 29403 2012-12-06
1710291455 Linda Ramsey Bright Clinical Nurse Specialist 103 Bee Street, Charleston, SC 29403 2010-08-05
1598990442 Colleen Lehn Degeorge Social Worker 198 Rutledge Avenue, Suite 8, Charleston, SC 29403 2009-05-21
1164618815 Diane Andrews Speech-Language Pathologist Musc Speech Language Pathology, 169 Ashley Ave Msc 335, Charleston, SC 29403 2007-09-17
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912515511 Naajah Hughes Nurse Practitioner 96 Jonathan Lucas Street Csb 428 Msc 608, Charleston, SC 29425-0001 2020-07-20
1528476793 Kacie Owens Nurse Practitioner 830 Pennslyvania Avenue, Suite 103, Charleston, WV 25302-3389 2014-07-31
1124214895 Elizabeth Zimmerman Thelan Nurse Practitioner 2051 Charlie Hall Blvd., Charleston, SC 29414 2007-09-17
1699305862 Katherine Gannon Kiesel Nurse Practitioner 2067 Charlie Hall Blvd, Charleston, SC 29414-5834 2020-01-16
1255979738 Gabrielle Amarante Nurse Practitioner 2067 Charlie Hall Blvd, Charleston, SC 29414-5834 2019-12-16
1396388393 Jessica Kristen Gardner Nurse Practitioner 171 Ashley Ave, Charleston, SC 29425-8900 2019-10-22
1114426814 Erin Hill Nurse Practitioner 1871 Savage Rd, Charleston, SC 29407-4726 2018-02-08
1255842910 Vanessa Lee Adams Nurse Practitioner 165 Ashley Ave, Charleston, SC 29425-8905 2017-10-20
1720524556 Christine Lee Butler Nurse Practitioner 1941 Savage Rd Ste 100e, Charleston, SC 29407-4788 2017-01-18
1487197844 Colleen Cusick Yazdi Nurse Practitioner 171 Ashley Ave, Charleston, SC 29425-8908 2016-12-02
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Competitor

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City CHARLESTON
Zip Code 29403

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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