Individual provider Active NPI

Angela Lynn Mackay, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1104577196
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015642 Issued in FL
Practice address
7242 Flood Reef
Pensacola, FL 32507-9433
Phone
(850) 987-0950
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 APRN11015642 FL Primary

Addresses

Primary practice location

7242 Flood Reef
Pensacola, FL 32507-9433

Mailing address

7242 Flood Reef
Pensacola, FL 32507-9433
Phone (850) 292-7572

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
APRN11015642FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sec Clinical Research, LLC PastSince Jan 1, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1104577196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7242 FLOOD REEF",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325079433",
            "telephone_number": "850-292-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7242 FLOOD REEF",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325079433",
            "telephone_number": "850-987-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.