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NPISignal

Individual Healthcare Provider

Jerry Lamont Mckenzie, M.D.

NPI Record: ActiveFamily Medicine — Geriatric Medicine
NPI1053679407
Mansfield, Texas

Provider's NPPES record last updated: December 11, 2024

Overview

Entity Type
Individual Healthcare Provider
NPI
1053679407
Primary Specialty
Family Medicine — Geriatric Medicine
Practice Location
Mansfield, Texas
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 20, 2026, 7:42 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Family Medicine

    Geriatric Medicine

    Allopathic & Osteopathic Physicians

    Primary

    A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

    Taxonomy code 207QG0300X
  • Emergency Medicine

    Allopathic & Osteopathic Physicians

    An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

    Taxonomy code 207P00000X
  • Student in an Organized Health Care Education/Training Program

    Student, Health Care

    An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

    Taxonomy code 390200000X

Provider-Reported License Information

Family Medicine (Texas)
R4786
Emergency Medicine (Arkansas)
E-8969
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

1720 E Broad St

Mansfield, Texas 76063-3400

Phone: (817) 453-5912

Additional Practice Location

845 Desco Ln

Grand Prairie, Texas 75051-1685

Phone: (817) 761-7876

Fax: (817) 635-6362

Additional Practice Location

3920 W Wheatland Rd Ste 152

Dallas, Texas 75237-3404

Phone: (214) 467-0432

Record Information

Enumeration Date
April 23, 2012
Provider's NPPES Record Last Updated
December 11, 2024
Certification Date
December 11, 2024
NPISignal NPPES Dataset
August 2026

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