STACEY W MCKENZIE (NPI# 1699768101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699768101 |
| Entity Type | Individual |
| Full Name | STACEY W MCKENZIE |
| Credential | MD |
| Practice Address |
2151 Century Ln Johnson City TN 37604-4469 |
| Mailing Address |
Po Box 70403 365 Stout Drive Johnson City TN 37614-1703 |
| Practice Telephone | 4239262500 |
| Practice Fax Number | 4239265999 |
| Mailing Telephone | 4234394515 |
| Mailing Fax Number | 4234395780 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2017-05-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
18756 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q010241 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023418530 | Stacey Mckenzie | Nurse Practitioner | 5445 Sky Ridge Rd, Charlestown, IN 47111-8949 | 2014-09-03 |
| 1447208970 | Stacey L Mckenzie | Physical Therapist | 210 E. Derenne Ave, Savannah, GA 31405 | 2006-05-05 |
| Street Address |
2151 CENTURY LN |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-4469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238914 | Rebecca A Morrison | Nurse Practitioner | 2151 Century Ln, Johnson City, TN 37604-4469 | 2005-07-07 |
| 1275169187 | Sudha Raj Kumar | Nurse Practitioner | 2151 Century Ln, Johnson City, TN 37604-4469 | 2020-03-23 |
| 1710522636 | Natalie Grace Wigle | Social Worker | 2151 Century Ln, Johnson City, TN 37604-4469 | 2019-11-14 |
| 1093281297 | Ernest David Maupin | Nurse Practitioner | 2151 Century Ln, Johnson City, TN 37604-4469 | 2018-10-16 |
| 1124593132 | East Tennessee State University | Social Worker | 2151 Century Ln, Johnson City, TN 37604-4469 | 2018-10-05 |
| 1760923536 | Tonja Schnelle | Nurse Practitioner | 2151 Century Ln, Johnson City, TN 37604-4469 | 2017-03-14 |
| 1477009215 | Amanda York | Social Worker | 2151 Century Ln, Johnson City, TN 37604-4469 | 2016-08-31 |
| 1770933186 | Sarah S Carlisle | Dentist | 2151 Century Ln, Johnson City, TN 37604-4469 | 2016-06-16 |
| 1154780716 | East Tennessee State University | Pharmacy | 2151 Century Ln, Johnson City, TN 37604-4469 | 2016-02-11 |
| 1831554575 | Paige R Mullins | Nurse Practitioner | 2151 Century Ln, Johnson City, TN 37604-4469 | 2015-12-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093253619 | Medical Education Assistance Corporation | Internal Medicine | 615 N State of Franklin Rd, Johnson City, TN 37604 | 2017-02-02 |
| 1760622971 | Vivek Vardhan Reddy Kandanati | Internal Medicine | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2009-02-27 |
| 1245411255 | Dima Youssef | Internal Medicine | 615 N State of Franklin Rd, Johnson City, TN 37604-8209 | 2007-11-19 |
| 1285813741 | Zhi Qiang Yao | Internal Medicine | 325 N State of Franklin Rd, Johnson City, TN 37604 | 2007-10-31 |
| 1780872358 | Lamis Wahid Ibrahim | Internal Medicine | 329 N State of Franklin Rd, Johnson City, TN 37604 | 2007-10-09 |
| 1265420046 | Wael Shams | Internal Medicine | 329 N State of Franklin Rd, Johnson City, TN 37604-6062 | 2005-10-06 |
| 1508853367 | Felix Sarubbi | Internal Medicine | 329 N State of Franklin Rd, Johnson City, TN 37604-6062 | 2005-10-05 |
| 1730175381 | James W Myers | Internal Medicine | 329 N State of Franklin Rd, Johnson City, TN 37604-6062 | 2005-09-20 |
| 1023003936 | Jonathan P Moorman | Internal Medicine | 329 N State of Franklin Rd, Johnson City, TN 37604-6062 | 2005-09-16 |
| 1780679266 | Christine H Fenlon | Internal Medicine | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2005-09-12 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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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.