Individual provider Active NPI

Maci McQueary, APRN

  • Family Nurse Practitioner
  • Campbellsville, KY
National Provider Identifier
1104430297
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014869 Issued in KY
Practice address
410 Hotchkiss St
Campbellsville, KY 42718-1340
Phone
(270) 465-0191
Fax
(270) 465-0463
NPI assigned
Sep 4, 2020
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3014869 KY Primary

Addresses

Primary practice location

410 Hotchkiss St
Campbellsville, KY 42718-1340

Mailing address

2503 Lone Valley Rd
Campbellsville, KY 42718-8213

Other names 1

  • Maci Lakin Christie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027001763 KY Practitioner - Nurse Practitioner 2567872856 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Hotchkiss St
Campbellsville, KY 42718-1340
Phone (270) 465-0191

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.9 of 100Reported as group
Quality
85.93
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3014869KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Regional Medical Group LLC Family CurrentSince Oct 21, 2020 Accepting new patients
Ep Medical LLC Family CurrentSince Jul 2, 2023 Accepting new patients
McQueary Family Medicine Inc Family CurrentSince Oct 12, 2021 Accepting new patients
Taylor Regional Medical Group, LLC Family CurrentSince Oct 21, 2020 Accepting new patients

Locations

500 N Bypass Rd
Campbellsville, KY 42718
Phone (270) 789-0577

500 N Bypass Rd
Ste C
Campbellsville, KY 42718
Phone (270) 789-0577

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

410 Hotchkiss St
Campbellsvlle, KY 42718
Phone (270) 465-0191

67 Kingswood Dr
Campbellsvlle, KY 42718
Phone (270) 465-2116

95 Kingswood Dr
Campbellsvlle, KY 42718
Phone (270) 465-3812

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1104430297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 LONE VALLEY RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427188213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 HOTCHKISS ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181340",
            "telephone_number": "270-465-0191",
            "fax_number": "270-465-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEARY",
        "first_name": "MACI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACI",
            "last_name": "CHRISTIE",
            "middle_name": "LAKIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.