=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386952299
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. JAMES BREW MCKENZIE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2010
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1439 CAMBRIDGE ST
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02139-1106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-665-1187
-----------------------------------------------------
Fax | 617-665-3449
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 25TH AVE N STE 1220
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37203-1640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-669-3579
-----------------------------------------------------
Fax | 615-622-8871
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | 4309
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------