Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

McKenzie Lively

Individual provider Nurse Practitioner · NPI 1356120471

McKenzie Lively is a Nurse Practitioner in Mountain Home, Arkansas. Qualified in 2023, 3 years ago. Practices with Pain Treatment Centers of America PLLC, a 72-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
3
Licensed in
AR
In the registry since
2023
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Practice location Address checks out

17 Medical Plz
Mountain Home, AR 72653-2918
Phone: (870) 508-5900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 122844 (AR)

Record details

NPI number1356120471
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 27, 2023
Last updated in NPPESSeptember 27, 2023
Certification dateSeptember 27, 2023
Mailing address190 Sawyer Holw, Pineville, AR 72566-8878

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Pain Treatment Centers Of America Pllc — 72 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Mountain Home