Individual provider Active NPI

Sarah Nicole Mackey, FNP-C

  • Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1275102113
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209023708 Issued in IL
Practice address
210 W McKinley Ave Ste 1
Decatur, IL 62526-5858
Phone
(217) 876-6600
Fax
(217) 876-6606
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209023708 IL Primary

Addresses

Primary practice location

210 W McKinley Ave Ste 1
Decatur, IL 62526-5858

Mailing address

210 W McKinley Ave Ste 1
Decatur, IL 62526-5858
Phone (217) 876-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211001001963 IL Practitioner - Nurse Practitioner 2769880905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cancer Care Specialists of Central Illinois SCGroup PAC ID 5991619116, 31 clinicians

Practice addresses (Care Compare)

210 W McKinley Ave
Suite 1
Decatur, IL 62526-5858
Phone (217) 877-9442

Hospital & facility affiliations

  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166
  • Pana Community Hospital Hospital, Pana, IL, CCN 141341

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209023708ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Care Specialists of Central Illinois, S.C. CurrentSince Feb 1, 2024 Accepting new patients
Cancer Care Specialists of Central Illinois, S.C CurrentSince Feb 1, 2024 Accepting new patients

Locations

210 W McKinley Ave
Ste 1
Decatur, IL 62526
Phone (217) 876-6600

210 W McKinley Ave
#1
Decatur, IL 62526
Phone (217) 877-9442

210 W McKinley Ave
Decatur, IL 62526
Phone (217) 876-8121

201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555

Interoperability endpoints

  • Direct secure messaging: smackeyrn288144@carlehiedirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1275102113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W MCKINLEY AVE STE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625265858",
            "telephone_number": "217-876-6600",
            "fax_number": "217-876-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W MCKINLEY AVE STE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625265858",
            "telephone_number": "217-876-6600",
            "fax_number": "217-876-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "SARAH",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.