Edward J Macke

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

APS.004440 Issued in OH

Practice address

1501 Madison Rd
Cincinnati, OH 45206

Phone

(513) 354-5200

NPI assigned

Jan 13, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1144860610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45206",
            "telephone_number": "513-354-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45206",
            "telephone_number": "513-354-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Edalbert Dr",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452397604",
            "country_code": "US",
            "telephone_number": "513-741-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKE",
        "first_name": "EDWARD",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.004440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rassan Mack
• Ronald Mack
• Tanika Mack, RN
• Tonya R Mack
• Tracy Yarnell Mack
• Nicole Ann Macke
• Laura Elizabeth Mackey
• Makilah Mackey
• Monica Lynette Mackey, NP
• Tyyonna Ren'Ee Mackey

• Peer Specialist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.