Katherine Grace Mackillop, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5151015293 Issued in MI

Practice address

5450 Fort St
Trenton, MI 48183-4601

Phone

(508) 974-5803

NPI assigned

Jun 23, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Western Carolina Physician Practices LLCGroup PAC ID 9032338975, 177 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harris Regional Hospital Hospital, Sylva, NC, CCN 340016

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.mackillop.1@9865.direct.athenahealth.com
• Direct secure messaging: kmackillop1244583@epic00.shdirect.org

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.

• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• DLP Western Carolina Physician Practices LLC

  • Diagnostic Radiology Physician
  • Clyde, NC
  • NPI 1932925062
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Harris Regional Hospital LLC

  • General Acute Care Hospital
  • Sylva, NC
  • NPI 1407962046
  Care Compare affiliation

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1225607120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FORT ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 FORT ST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "508-974-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKILLOP",
        "first_name": "KATHERINE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5151015293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katherine.mackillop@beaumont.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "5450 Fort St",
            "city": "Trenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481834601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Luketich, DO
• Jacob Dante Lupini, DDS
• Genny Lynn Luppino, LPC
• Morgan Rose Lyons
• Elizabeth Marie Macdonald
• David Malicke, D.O.
• Darin L Mann, DO
• Marcia Vanderbroek DO PC
• Margaret a Lutsic DO PC
• Emery Martin

• Obstetrics & Gynecology Physician in Trenton, MI
• Providers in Trenton, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.