Active NPI
Jessie G Mackey, CCC-SLP
- Speech-Language Pathologist
- Mannford, OK
National Provider Identifier
1013504349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5143
- Practice address
- 154 S. Coonrod Dr.
Mannford, OK 74044 - Phone
- (918) 281-5465
- NPI assigned
- Dec 21, 2020
- Last updated
- Dec 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5143 | OK | Primary |
Addresses
Primary practice location
154 S. Coonrod Dr.
Mannford, OK 74044
Mailing address
154 S. Coonrod Dr.
Mannford, OK 74044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Mannford | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dragonfly Mental Health Center LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Mannford, OK
- NPI 1578150819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608508800000",
"number": "1013504349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 S. COONROD DR.",
"city": "MANNFORD",
"state": "OK",
"postal_code": "74044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 S. COONROD DR.",
"city": "MANNFORD",
"state": "OK",
"postal_code": "74044",
"telephone_number": "918-281-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKEY",
"first_name": "JESSIE",
"middle_name": "G",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-21",
"last_updated": "2020-12-21",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "5143",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONS",
"identifier": "NONE",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Mannford",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "154 S. Conrad Ave",
"city": "Mannford",
"state": "OK",
"country_code": "US",
"postal_code": "74044",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mannford, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.