MACKENZIE DERMATOLOGY
NPI 1396971958
Dermatology - Procedural Dermatology in Prescott, AZ

Q: What is Keith A Mackenzie Do PC's NPI number?

The NPI number for Keith A Mackenzie Do PC is 1396971958. It was assigned to this organization in the NPPES registry on June 9, 2009. The provider is doing business as Mackenzie Dermatology.

Q: What is Keith A Mackenzie Do PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Active since June 09, 2009CLIA 03D2011524 · Certificate of Compliance

3190 CLEARWATER DR, PRESCOTT, AZ 86305(928) 541-1312(928) 541-0002 Get Directions Write a Review

NPPES record last updated: October 18, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mackenzie Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACKENZIE DERMATOLOGY (NPI 1396971958) is a healthcare organization registered as a procedural dermatology in Prescott, Arizona and active in the NPI registry since June 2009. The organization holds a CLIA Certificate of Compliance certificate valid through October 28, 2027 and lists Jamie Quinn, Credentialing/billing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1396971958

Entity TypeOrganization

Primary Taxonomy207NS0135X

Legal Business NameKEITH A MACKENZIE DO PC

Location Address3190 CLEARWATER DRPrescott, AZ 86305-7131

Mailing Address3190 Clearwater DrPrescott, AZ 86305-7131 · (928) 541-1312 · Fax (928) 541-0002

Phone(928) 541-1312

Fax(928) 541-0002

Organization SubpartNo

Authorized OfficialJamie QuinnCredentialing/billing Supervisor · (928) 541-1312

Enumeration DateJune 9, 2009

Last NPPES UpdateOctober 18, 2017

✔ NPI 1396971958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

License✔ Licensed in AZ · 3225

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

3190 CLEARWATER DR, Prescott, AZ 86305

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Other Names 1

Doing Business AsMackenzie Dermatology

Other Identifiers 3

Medicare PIN20138AZ

Medicaid390766AZ

Medicare UPING53808

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 03D2011524

Mackenzie Dermatology · Prescott, AZ

Active · expires Oct 28, 2027

CLIA Number03D2011524

Laboratory TypePhysician Office

Certificate Effective DateOctober 29, 2025

Certificate Expiration DateOctober 28, 2027

Laboratory DirectorKeith Mackenzie

Laboratory Phone(928) 541-1312

Laboratory LocationMackenzie Dermatology3190 Clearwater Dr, Prescott, AZ 86305

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY CARLSON STOVER NP-C

Nurse Practitioner

3190 CLEARWATER DR
PRESCOTT, AZ 86305

Yavapai County (928) 541-1312

DR. KEITH ANDREW MACKENZIE D.O.

Dermatology (Procedural Dermatology)

3190 CLEARWATER DR
PRESCOTT, AZ 86305

Yavapai County (928) 541-1312

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith A Mackenzie Do PC's NPI number?

The NPI number for Keith A Mackenzie Do PC is 1396971958. It was assigned to this organization in the NPPES registry on June 9, 2009. The provider is doing business as Mackenzie Dermatology.

Where is Keith A Mackenzie Do PC located?

Keith A Mackenzie Do PC is located at 3190 Clearwater Dr, Prescott, AZ 86305. The listed phone number is (928) 541-1312.

What is Keith A Mackenzie Do PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Does Keith A Mackenzie Do PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 03D2011524) is associated with this NPI, valid through October 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Keith A Mackenzie Do PC was last updated on October 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.