Javonda Enitra Mackins

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

341331 Issued in NY

Practice address

620 Madison St
Syracuse, NY 13210-2319

Phone

(315) 426-3985

Fax

(315) 426-3605

NPI assigned

Aug 7, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1215767736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 PARK AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135013810",
            "telephone_number": "732-215-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MADISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102319",
            "telephone_number": "315-426-3985",
            "fax_number": "315-426-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINS",
        "first_name": "JAVONDA",
        "middle_name": "ENITRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "341331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Machovec, PA
• Shelby Macintosh, PT, DPT
• Sherradyn Lee Mack, PA
• Phillip Mackewicz
• Jennifer E Mackey, MD
• Erin M Macko, M.S., CCC-SLP
• Stanley J Mackowiak, MD
• Brian Maclaughlin, MD
• Lauren Macshane, MD
• Alexandra Peck Madden, LMSW

• Licensed Practical Nurse in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.