MRS. MCKENZIE RENEE DOLPH (PT, DPT) – Physical Therapist, NPI 1164098869

MRS. MCKENZIE RENEE DOLPH (PT, DPT) is a healthcare provider. based in Fremont, Nebraska. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. The NPI Number for MRS. MCKENZIE RENEE DOLPH (PT, DPT) is 1164098869

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MCKENZIE RENEE DOLPH (PT, DPT)
NPI
1164098869
Phone
(402) 721-1112
Address
2123 E 23RD AVE S
Enumeration Date
2 June 2021
Last Update Date
2 June 2021

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
4028198477
Graduation Year
2021 (5 years ago)
PAC ID
4082014220
Group Practice PAC ID
5991988693
Professional Enrollment ID
I20210610000431
Address ID
NE681241717OM7686XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

841 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NE

Provider Addresses for MRS. MCKENZIE RENEE DOLPH (PT, DPT)

  • 2123 E 23RD AVE S

    FREMONT, NE 680252498

    Phone: (402) 721-1112

    Fax: (402) 721-1113

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-06-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210610000431IPhysical Therapist In Private PracticeNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68025)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991988693View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeNE
Physical Therapist In Private PracticeNE
Occupational Therapist In Private PracticeNE
-IA
Occupational Therapist In Private PracticeNE
Occupational Therapist In Private PracticeNE
Occupational Therapist In Private PracticeNE
Qualified Speech Language PathologistNE
Occupational Therapist In Private PracticeNE

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. MCKENZIE RENEE DOLPH (PT, DPT)?
NPI 1164098869 is assigned to MRS. MCKENZIE RENEE DOLPH (PT, DPT) under the national enumeration system.
Does this profile mean MRS. MCKENZIE RENEE DOLPH (PT, DPT) is currently active?
Yes — MRS. MCKENZIE RENEE DOLPH (PT, DPT) appears active in the national provider directory.
What does MRS. MCKENZIE RENEE DOLPH (PT, DPT) treat or focus on?
Patients typically see MRS. MCKENZIE RENEE DOLPH (PT, DPT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is MRS. MCKENZIE RENEE DOLPH (PT, DPT)'s primary listing?
We display Fremont, Nebraska because that is what the record indicates for MRS. MCKENZIE RENEE DOLPH (PT, DPT).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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