Individual provider Active NPI

Mary-Katherine McKenzie Boatright, NP-C

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1114661303
Registry record updated Apr 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN284149 Issued in GA
Practice address
556 3Rd St Ste a
Macon, GA 31201-7993
Phone
(478) 743-2472
NPI assigned
Apr 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2022

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 RN284149 GA Primary

Addresses

Primary practice location

556 3Rd St Ste a
Macon, GA 31201-7993

Mailing address

391 Rivermist Rd
Juliette, GA 31046-3608
Phone (912) 402-9160

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

State licenses

LicenseStateTypeSpecialty
RN284149GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Specialists of the South CurrentSince May 1, 2022 Accepting new patients

Locations

556 3rd St
Ste A
Macon, GA 31201
Phone (478) 743-2209

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20306/brand/1/csg/1/fhir/r4

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": "1650758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650758400000",
    "number": "1114661303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 RIVERMIST RD",
            "city": "JULIETTE",
            "state": "GA",
            "postal_code": "310463608",
            "telephone_number": "912-402-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 3RD ST STE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017993",
            "telephone_number": "478-743-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATRIGHT",
        "first_name": "MARY-KATHERINE",
        "middle_name": "MCKENZIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-24",
        "last_updated": "2022-04-24",
        "certification_date": "2022-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN284149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2022; 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.