Mrs Latisha Mckenzie, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Georgetown, Georgia. Her current practice location is
23 Old School Rd, Georgetown, Georgia. You can reach out to her office (for appointments etc.) via phone at
(229) 334-9353.
Mrs Latisha Mckenzie is licensed to practice in Georgia (license number GAA-NP001043) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1821769878.
Provider's Profile
| Full Name | Mrs Latisha Mckenzie |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 23 Old School Rd, Georgetown, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1821769878
- Provider Enumeration Date: 09/21/2021
- Last Update Date: 09/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 9335525450
- Enrollment ID: I20220927002793
Medical Identifiers
Medical identifiers for Mrs Latisha Mckenzie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1821769878 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | GAA-NP001043 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Latisha Mckenzie allows following entities to bill medicare on her behalf.
| Entity Name | Careconnect Health Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063436624 PECOS PAC ID: 7810980794 Enrollment ID: O20040406001286 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Latisha Mckenzie is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mrs Latisha Mckenzie, NURSE PRACTITIONER 23 Old School Rd, Georgetown, GA 39854-4627 Ph: (229) 334-9353 | Mrs Latisha Mckenzie, NURSE PRACTITIONER 23 Old School Rd, Georgetown, GA 39854-4627 Ph: (229) 334-9353 |
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