Individual provider Active NPI

Nancy S. Macklin, N.P.

  • Adult Health Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1275631442
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71000116A Issued in IN
Practice address
600 N Jordan Ave
Bloomington, IN 47405-3190
Phone
(812) 855-5005
Fax
(812) 855-4628
NPI assigned
Sep 20, 2006
Last updated
Jul 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71000116A IN Primary

Addresses

Primary practice location

600 N Jordan Ave
Bloomington, IN 47405-3190

Mailing address

600 N Jordan Ave
Bloomington, IN 47405-3190
Phone (812) 855-5005

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71000116AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1275631442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-5005",
            "fax_number": "812-855-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-5005",
            "fax_number": "812-855-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "NANCY",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000116A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.