Individual provider Active NPI

Scott Alan Mackey, LMSW

  • Social Worker
  • Hermitage, MO
National Provider Identifier
1164998936
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2018036325 Issued in MO
Practice address
18614 Jackson Street
Hermitage, MO 65668-0125
Phone
(417) 745-2121
Fax
(417) 745-0056
NPI assigned
Oct 19, 2018
Last updated
Oct 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2018036325 MO Primary

Addresses

Primary practice location

18614 Jackson Street
Hermitage, MO 65668-0125

Mailing address

PO Box 125
Hermitage, MO 65668-0125
Phone (417) 745-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181117000446 MO Practitioner - Clinical Social Worker 3173877750 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018036325MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Resource Group CurrentSince Nov 1, 2018 Accepting new patients
Ozarks Resource Group CurrentSince Nov 1, 2018 Accepting new patients

Locations

18614 Jackson St
Hermitage, MO 65668
Phone (417) 745-0103

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1164998936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680125",
            "telephone_number": "417-745-2121",
            "fax_number": "417-745-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18614 JACKSON STREET",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680125",
            "telephone_number": "417-745-2121",
            "fax_number": "417-745-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2018036325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, MO

Sources for this page

Verify at the official NPI Registry.