Active NPI
Essie B Mack, M.T.
- Medical Technologist
- Denham Springs, LA
National Provider Identifier
1124224142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- CLP.G00606-GEN
- Practice address
- 1567 S Range Ave
Denham Springs, LA 70726-5201 - Phone
- (225) 665-3500
- Fax
- (225) 665-3518
- NPI assigned
- Jun 26, 2007
- 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 |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | CLP.G00606-GEN | LA | Primary |
Addresses
Primary practice location
1567 S Range Ave
Denham Springs, LA 70726-5201
Mailing address
1567 S Range Ave
Denham Springs, LA 70726-5201
Phone (225) 665-3500
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
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CLP.G00606-GEN | LA | MD | Medical Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trauma Specialists, Apmc | Past | 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.
-
- Independent Medical Examiner Physician
- Denham Springs, LA
- NPI 1700082229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124224142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1567 S RANGE AVE",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707265201",
"telephone_number": "225-665-3500",
"fax_number": "225-665-3518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1567 S RANGE AVE",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707265201",
"telephone_number": "225-665-3500",
"fax_number": "225-665-3518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "ESSIE",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "LA",
"license": "CLP.G00606-GEN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denham Springs, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.