Individual provider Active NPI

Laurette Mackinnon, D.C.

  • Chiropractor
  • Naples, FL
National Provider Identifier
1194881227
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11727 Issued in FL
Practice address
13020 Livingston Road, Suite 14
Naples, FL 34105-5021
Phone
(239) 263-3330
Fax
(978) 374-9716
NPI assigned
Jan 1, 2007
Last updated
Feb 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11727 FL Primary
Chiropractor 111N00000X 2116 MA

Addresses

Primary practice location

13020 Livingston Road, Suite 14
Naples, FL 34105-5021

Mailing address

13020 Livingston Road, Suite 14
Naples, FL 34105-5021
Phone (239) 263-3330

Other identifiers 2

IdentifierTypeStateIssuer
Y36564OtherMABCBSMA INDIVIDUAL NUMBER
Y39421OtherMABCBSMA GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220518000123 FL Practitioner - Chiropractic 8527078328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Synergy Integrated Healthcare IncGroup PAC ID 9436469194, 9 clinicians

Practice addresses (Care Compare)

13020 Livingston Rd
Suite 14
Naples, FL 34105-5023
Phone (239) 263-3330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Integrated Healthcare Inc Chiropractor CurrentSince Feb 8, 2022 Accepting new patients
Chiropractic Health Care Chiropractor Past Accepting new patients
Synergy Chiropractic and Health Center PA Chiropractor PastSince Feb 23, 2020 Accepting new patients

Locations

13020 Livingston Rd
Ste 14
Naples, FL 34105
Phone (239) 263-3330

Organizations & group practices 3

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": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1194881227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 LIVINGSTON ROAD, SUITE 14",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341055021",
            "telephone_number": "239-263-3330",
            "fax_number": "978-374-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 LIVINGSTON ROAD, SUITE 14",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341055021",
            "telephone_number": "239-263-3330",
            "fax_number": "978-374-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "LAURETTE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11727",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2116",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA INDIVIDUAL NUMBER",
            "identifier": "Y36564",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA GROUP NUMBER",
            "identifier": "Y39421",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.