DR. WAYNE MACKENZIE NURSE PRACTITIONER NPI 1144589086

NPI Information

NPI: 1144589086
Provider Name: DR. WAYNE MACKENZIE, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
319 N LITCHFIELD RD STE 105
GOODYEAR, AZ
ZIP 85338
Phone: (623) 224-1162
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DR. Wayne Mackenzie, NURSE PRACTITIONER is a psychiatric/mental health nurse practitioner in Goodyear, AZ with 12 years of experience. DR. Wayne Mackenzie, NURSE PRACTITIONER NPI is 1144589086. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduation Year:2012

The provider's business location address is:

319 N LITCHFIELD RD STE 105
GOODYEAR, AZ
ZIP 85338-256
Phone: (623) 224-1162
Fax: (888) 346-3899

The NPI 1144589086 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/13/2012 and was last updated on 1/31/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP4913	ARIZONA	Yes
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201250163NP	OREGON	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	707607	TEXAS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	QXIPQ0000098776	MEDICAID	ARIZONA
2	804045	OTHER	ARIZONA	AHCCCS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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