Individual provider Active NPI

Mackenzie Pierce

  • Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1013840222
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4057164 Issued in KY
Practice address
2501 Kentucky Ave
Paducah, KY 42003-3813
Phone
(270) 575-2100
NPI assigned
Jun 5, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4057164 KY Primary

Addresses

Primary practice location

2501 Kentucky Ave
Paducah, KY 42003-3813

Mailing address

140 Gateway CT
Benton, KY 42025-7106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4057164KYMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1013840222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GATEWAY CT",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KENTUCKY AVE",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033813",
            "telephone_number": "270-575-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4057164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.