MACKENZIE PRANDI (NPI# 1659342327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659342327 |
| Entity Type | Individual |
| Full Name | MACKENZIE PRANDI |
| Credential | PA-C |
| Practice Address |
1900 Electric Rd Salem VA 24153 |
| Mailing Address |
2000 Health Park Dr Fl Hp2 Brentwood TN 37027-4525 |
| Practice Telephone | 5404444020 |
| Practice Fax Number | 5404444021 |
| Mailing Telephone | 6153737600 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110002209 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010244161 | 05 | |
| VA | MEDICARE RAILROAD | P00304575 | 01 |
| VA | 1659342327 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1802 Braeburn Dr, Salem, VA 241537357 | 5407723530 | 5407762036 |
| 101 Knotbreak Rd, Salem, VA 241535404 | 5404444020 | 5404444021 |
| Street Address |
1900 ELECTRIC RD |
| City | SALEM |
| State | VA |
| Zip Code | 24153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841281730 | Norberto Paras | Internal Medicine | 1900 Electric Rd, Salem, VA 24153-7474 | 2005-10-31 |
| 1376159335 | Hanna-nicole Stanley | Physician Assistant | 1900 Electric Rd, Salem, VA 24153-7494 | 2020-09-16 |
| 1306469614 | Faraaz Bhatti | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7494 | 2020-05-20 |
| 1336761972 | Tyler Starman | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7494 | 2020-05-16 |
| 1619599644 | Christopher Patrick Cooney | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7474 | 2020-05-13 |
| 1629690987 | Emily Yau | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7474 | 2020-05-10 |
| 1124640461 | Libeneur Loriston | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7474 | 2020-05-09 |
| 1861014227 | Brandon Kuley | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7474 | 2020-05-08 |
| 1043832413 | Beverly Nyokabi | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7494 | 2020-05-08 |
| 1962024398 | Kathryn Garcia | Student in an Organized Health Care Education/Training Program | 1900 Electric Rd, Salem, VA 24153-7494 | 2020-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
| 1639614852 | Gregory Bull | Physician Assistant | 622 Fernwood Dr, Salem, VA 24153-2654 | 2016-12-24 |
| 1841648862 | Theron J Wiese | Physician Assistant | 1395 Commercial St Se, Salem, OR 97302-4205 | 2016-05-31 |
| 1922329697 | Charleen Ann Thorburn | Physician Assistant | 22 Keewaydin Dr, Salem, NH 03079-2839 | 2010-06-17 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1215912712 | Amy Gouley | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2005-12-07 |
| 1306827100 | William Earle Williams | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2005-11-08 |
| 1700485224 | Roderick Mao | Physician Assistant | 159 N Broadway, Salem, NH 03079-2136 | 2020-10-26 |
| 1447719752 | Christine Nicole Jeffries | Physician Assistant | 360 Church St Se, Salem, OR 97301-3796 | 2019-03-16 |
| 1265999338 | Brolin Johnson | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2019-02-26 |
| Find all providers in SALEM | ||||
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| 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.