DR. JERRY LAMONT MCKENZIE (NPI# 1053679407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053679407 |
| Entity Type | Individual |
| Full Name | DR. JERRY LAMONT MCKENZIE |
| Credential | M.D. |
| Practice Address |
825 Fairfax Ave Suite 410 Norfolk VA 23507-1914 |
| Practice Telephone | 7574467934 |
| Mailing Telephone | 7574467934 |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2016-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | E-8969 | AR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770893372 | Jerry Dean Mckenzie | Personal Emergency Response Attendant | 7425 E Hwy 266, Claremore, OK 74019 | 2010-10-15 |
| Street Address |
825 FAIRFAX AVE SUITE 410 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538167796 | Richard Norman Willard | Obstetrics & Gynecology | 825 Fairfax Ave, Suite 310, Norfolk, VA 23507-1914 | 2005-07-12 |
| 1053930800 | Seth Warren | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-04-12 |
| 1235768730 | Chelsea Time Rubis | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-04-06 |
| 1689203317 | Kristen Mcconnell Gogoli | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1912 | 2020-04-04 |
| 1003445040 | Mruna Jaymin Patel | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-04-02 |
| 1750919130 | Mary Elizabeth Wade | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1912 | 2020-03-31 |
| 1982232773 | Bradley Nicolas Cotrina | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-03-29 |
| 1841827821 | Miles Reese | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-03-27 |
| 1053948083 | Colin Neils Chao | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-03-27 |
| 1164984290 | Una Kosarac | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2019-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336627207 | Sentara Medical Group | Emergency Medicine | 844 Kempsville Rd Ste 103, Norfolk, VA 23502 | 2018-08-02 |
| 1487161139 | Me Urgent Care Nebraska, Inc | Emergency Medicine | 1130 S 13th St Ste 100, Norfolk, NE 68701-5733 | 2018-01-03 |
| 1730542028 | Mark Noble | Emergency Medicine | 6379 Center Dr, Norfolk, VA 23502-4102 | 2016-04-04 |
| 1043509714 | Kaci Elizabeth Gogel | Emergency Medicine | 600 Gresham Dr Rm 304, Emergency Department, Norfolk, VA 23507-1904 | 2011-04-04 |
| 1477796936 | Peter Andrew Byers | Emergency Medicine | 600 Gresham Dr. Raleigh Blvd-304, Evms Emergency Medicine-, Norfolk, VA 23507-1999 | 2009-04-14 |
| 1750542817 | Miguel Angel Cabrera | Emergency Medicine | 1600 Granby St Apt 245, Norfolk, VA 23510-2642 | 2008-06-21 |
| 1245490051 | Virginia M Stewart | Emergency Medicine | 358 Mowbray Arch, Suite 203, Norfolk, VA 23507-2219 | 2008-06-15 |
| 1881870442 | Gene A Germano | Emergency Medicine | 850 Tidewater Dr Ste A, Norfolk, VA 23504-3300 | 2008-01-14 |
| 1437280807 | Michael Glenn Penny | Emergency Medicine | U S Marine Corps Forces Command, Health Services Support, 1468 Ingram Street, Norfolk, VA 23551-2596 | 2007-03-08 |
| 1871657171 | Jerry Lynn Mothershead | Emergency Medicine | 707 Westover Ave, Norfolk, VA 23507-1622 | 2006-12-20 |
| Find all providers in NORFOLK | ||||
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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.