MCKENZIE MEDICAL CENTER (NPI# 1841696192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841696192 |
| Entity Type | Organization |
| Organization Name | MCKENZIE MEDICAL CENTER |
| Other Organization Name | MMC URGENT CARE CLINIC |
| Practice Address |
205 Hospital Dr Suite A Mc Kenzie TN 38201-1649 |
| Practice Telephone | 7313527907 |
| Practice Fax Number | 7313524459 |
| Mailing Telephone | 7313527907 |
| Mailing Fax Number | 7313524459 |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2018-10-24 |
| Authorized Official Name | LISA KAY PAGE (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 7313527907 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCKENZIE MEDICAL CENTER, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD15682 | TN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD23833 | TN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD46412 | TN | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | MD45034 | TN | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | PA1262 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN6244 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | GROUP MEDICAID | 3380640 | 01 |
| TN | GROUP MEDICARE | 3380640 | 01 |
| Other Name | Type Code |
|---|---|
| MMC URGENT CARE CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790075281 | Mckenzie Medical Center | Pharmacy | 136 S Wilson St # B, Dresden, TN 38225-1133 | 2011-04-18 |
| 1225267479 | Mckenzie Medical Center | Clinic/Center | 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 | 2009-07-09 |
| Street Address |
205 HOSPITAL DR SUITE A |
| City | MC KENZIE |
| State | TN |
| Zip Code | 38201-1649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455287 | Bryan Hale Merrick | Internal Medicine | 205 Hospital Dr, Ste A, Mc Kenzie, TN 38201-1649 | 2005-05-24 |
| 1588111850 | Christy Michelle Dougherty | Nurse Practitioner | 205 Hospital Dr, Ste A, Mc Kenzie, TN 38201-1649 | 2016-09-05 |
| 1083079487 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 205 Hospital Dr, Suite Q, Mc Kenzie, TN 38201-1649 | 2015-12-30 |
| 1225400484 | Beth Mitchell Graves | Nurse Practitioner | 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 | 2015-10-28 |
| 1609253509 | Home Medical Products, Inc | Durable Medical Equipment & Medical Supplies | 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 | 2015-04-29 |
| 1164814158 | Laura Baker | Nurse Practitioner | 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 | 2015-02-27 |
| 1144644246 | Lori Beth Holladay | Nurse Practitioner | 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 | 2014-02-10 |
| 1750710331 | Ccc Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 205 Hospital Dr, Mc Kenzie, TN 38201-1649 | 2013-11-05 |
| 1013359538 | Kelly E Rawls | Physician Assistant | 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201-1649 | 2013-07-25 |
| 1033418447 | Advanced Diagnostic Center LLC | Clinic/Center | 205 Hospital Dr, Suite C, Mc Kenzie, TN 38201-1649 | 2011-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912410887 | Tester Chiropractic, Pllc | Chiropractor | 62 Hospital Dr, Mc Kenzie, TN 38201 | 2017-11-14 |
| 1669910907 | Sherry Denise Connell | Behavioral Analyst | 145 Bethel Court, Bethel Autism Institute, Mckenzie, TN 38201 | 2017-02-07 |
| 1891249645 | Jennifer Rene Jennings | Nurse Practitioner | 205 Hospital Drive, Suite A, Mckenzie, TN 38201 | 2016-08-10 |
| 1336525211 | One Chiropractic, Pllc | Chiropractor | 62 Hospital Dr., Mckenzie, TN 38201 | 2015-08-03 |
| 1538567367 | Ashley Tester | Chiropractor | One Chiropractic, 62 Hospital Drive, Mckenzie, TN 38201 | 2014-12-10 |
| 1407996762 | Trent Wade Borders | Radiology | 205 Hospital Drvie, Suite A, Mckenzie, TN 38201 | 2007-02-07 |
| 1740382944 | James D Padgett | Dentist | 1934 Cedar Sta, Mckenzie, TN 38201 | 2006-09-01 |
| 1164533733 | Ambulance Services of Mckenzie, Inc. | Ambulance | 161 Hospital Drive, Mckenzie, TN 38201 | 2006-08-31 |
| 1245894724 | Gyu Chang Jo | Nurse Practitioner | 205 Hospital Dr Ste A, Mc Kenzie, TN 38201 | 2019-04-30 |
| 1194244772 | Christian Care Center of Mckenzie LLC | Nursing Facility/Intermediate Care Facility | 150 Oak Manor Rd, Mc Kenzie, TN 38201 | 2017-09-14 |
| Find all providers in zip 38201 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134749906 | Three Rivers Medical | Clinic/Center | 2725 E Governor John Sevier Hwy, Knoxville, TN 37914-6620 | 2020-04-22 |
| 1487273702 | Sanitas Medical Center of Tennessee PC | Clinic/Center | 1632 Memorial Blvd Ste 1646, Murfreesboro, TN 37129-2104 | 2020-04-16 |
| 1154980639 | Zup Medical Services, LLC | Clinic/Center | 4576 Poplar Avenue, Memphis, TN 38117 | 2019-06-10 |
| 1194380568 | Advanced Urgent Care Pllc | Clinic/Center | 455 N Chancery St Ste A, Mcminnville, TN 37110-2049 | 2019-05-01 |
| 1295208874 | Lwc Sevice Providers LLP | Clinic/Center | 111 Ellison Rd Ste 2, La Follette, TN 37766-3025 | 2019-01-07 |
| 1639655368 | Bunker Hill Staffing Urgent Care LLC | Clinic/Center | 1300 Bunker Hill Rd Ste B, Cookeville, TN 38506 | 2018-07-16 |
| 1386159523 | Wellmont Medical Associates, Inc. | Clinic/Center | 1021 Coolidge St Ste 4, Greeneville, TN 37743-5986 | 2017-12-11 |
| 1245754043 | Green River Medical Clinic, LLC | Clinic/Center | 315 Robert Rose Dr Ste F, Murfreesboro, TN 37129-6361 | 2017-08-02 |
| 1235669680 | Uhs Ventures | Clinic/Center | 1130 Middle Creek Rd Ste 290, Sevierville, TN 37862-3051 | 2017-06-19 |
| 1477087658 | Urgent Care Enterprise LLC | Clinic/Center | 5304 Cane Ridge Rd, Antioch, TN 37013-3839 | 2017-04-14 |
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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.