NPIMap

Organization Active NPI

Mackey Family Practice, PA

  • Family Medicine Physician
  • Lancaster, SC
National Provider Identifier
1265426167
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MACKEY FAMILY PRACTICE, PA
Practice address
1025 W Meeting St
Suite 200
Lancaster, SC 29720-2204
Phone
(803) 285-7414
Fax
(803) 283-4329
NPI assigned
Sep 7, 2005
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Dr. Keith D Shealy, M.D.NPI 1578557153
Title
Owner
Phone
(803) 285-7414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Medical Physician Assistant 363AM0700X 2674 SC
Nurse Practitioner 363L00000X 20303 SC

Addresses

Primary practice location

1025 W Meeting St
Suite 200
Lancaster, SC 29720-2204

Mailing address

1025 W Meeting St
Suite 200
Lancaster, SC 29720-2204
Phone (803) 285-7414

Other practice location 1

8351 Charlotte Hwy Ste 200
Indian Land, SC 29707-6553
Phone (803) 285-7414

Other identifiers 1

IdentifierTypeStateIssuer
GP0641MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000584 SC Part B Supplier - Clinic/Group Practice 7911816046 Receives reassigned benefits from 10 practitioners
Practice locations: Lancaster, SC; Indian Land, SC

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1265426167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W MEETING ST",
            "address_2": "SUITE 200",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202204",
            "telephone_number": "803-285-7414",
            "fax_number": "803-283-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W MEETING ST",
            "address_2": "SUITE 200",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202204",
            "telephone_number": "803-285-7414",
            "fax_number": "803-283-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8351 Charlotte Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indian Land",
            "state": "SC",
            "postal_code": "297076553",
            "country_code": "US",
            "telephone_number": "803-285-7414",
            "fax_number": "803-283-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MACKEY FAMILY PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "SHEALY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-285-7414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2674",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "20303",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0641",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.