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

Zachary H McKenty, PHYSICIANASSISTANT

Individual provider Independent Duty Medical Technicians · NPI 1407190812

Zachary H McKenty, PHYSICIANASSISTANT is a Physician Assistant in Carbondale, Illinois. Graduated from Southern Illinois University School of Medicine in 2020, 6 years ago. Practices with SSM Health Care Group, a 923-clinician group and accepts Medicare assignment.

Years since qualifying
6
Trained at
Southern Illinois University School of Medicine
In the registry since
2012
Specialties on file
2

Practice location Address checks out

300 W Oak St
Carbondale, IL 62901-1400
Phone: (618) 453-8850
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Independent Duty Medical Technicians Taxonomy 1710I1003X

Record details

NPI number1407190812
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedNovember 26, 2012
Last updated in NPPESJune 10, 2020
Certification dateJune 10, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare