Active NPI
Clarisse Mackay, FNP-C
- Nurse Practitioner
- Vista, CA
National Provider Identifier
1235992736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95028806
- Practice address
- 380 S Melrose Dr Ste 415
Vista, CA 92081-6655 - Phone
- (877) 267-8861
- NPI assigned
- Feb 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95028806 | CA | Primary |
Addresses
Primary practice location
380 S Melrose Dr Ste 415
Vista, CA 92081-6655
Mailing address
PO Box 3346
Cypress, CA 90630-7346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95028806 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1235992736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3346",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906307346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 S MELROSE DR STE 415",
"city": "VISTA",
"state": "CA",
"postal_code": "920816655",
"telephone_number": "877-267-8861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKAY",
"first_name": "CLARISSE",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-06",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95028806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.