Active NPI
Timothy Walton Mackey, M.D.
- Pediatrics Physician
- Riverside, CA
National Provider Identifier
1265519557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A46067
- Practice address
- 6950 Brockton Ave
Riverside, CA 92506-3831 - Phone
- (951) 686-8223
- Fax
- (951) 686-9617
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A46067 | CA | Primary |
Addresses
Primary practice location
6950 Brockton Ave
Riverside, CA 92506-3831
Mailing address
6950 Brockton Ave
Riverside, CA 92506-3831
Phone (951) 686-8223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A46067 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Medical Group of Riverside Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Riverside, CA
- NPI 1336227362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265519557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6950 BROCKTON AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063831",
"telephone_number": "951-686-8223",
"fax_number": "951-686-9617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6950 BROCKTON AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063831",
"telephone_number": "951-686-8223",
"fax_number": "951-686-9617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKEY",
"first_name": "TIMOTHY",
"middle_name": "WALTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A46067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.