Emili Rachele Mack, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2005-01260 Issued in NC

Practice address

3721 Lynn Rd Ste 104
Raleigh, NC 27613-3855

Phone

(919) 825-3600

Fax

(984) 200-6001

NPI assigned

Sep 7, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Mack Pediatrics PLLC

  dba Mack Pediatrics

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1881169514
  NPD Authorized official
• Goldsboro Pediatrics PA

  • Pediatrics Physician
  • Goldsboro, NC
  • NPI 1427125269
  NPD (past)
• Oberlin Road Pediatrics, PA

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1881667251
  NPD (past)
• Shore Fun Pediatrics

  • Pediatrics Physician
  • Supply, NC
  • NPI 1750420428
  NPD (past)
• Whiteville Medical Associates PA

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1902963937

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184618019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 LYNN RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276133855",
            "telephone_number": "919-825-3600",
            "fax_number": "984-200-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 LYNN RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276133855",
            "telephone_number": "919-825-3600",
            "fax_number": "984-200-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Doctors Cir",
            "address_2": "Suite #3",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284624088",
            "country_code": "US",
            "telephone_number": "910-754-7075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1321 Oberlin Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276082052",
            "country_code": "US",
            "telephone_number": "919-828-4747",
            "fax_number": "919-828-6765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "EMILI",
        "middle_name": "RACHELE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2005-01260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "2005-01260",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902210",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Dale Machiele, DO
• Anna Elaine Machin, LCSWA
• Mack Pediatrics PLLC (Mack Pediatrics)
• Brittany Mack
• Dorothy Theresia Mack
• Laila Amani Mack
• Shineka Latoya Mack, PMHNP
• Sydney Maitland Mack
• Carla Genevieve Mackenzie, LCAS, LCSW
• Kerry Keldon Mackey Sr.

• Pediatrics Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.