Mary Kackley

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP1039064 Issued in DC

Practice address

5255 Loughboro Rd NW
Washington, DC 20016-2633

Phone

(202) 537-4000

Fax

(202) 537-4588

NPI assigned

Sep 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Johns Hopkins UniversityGroup PAC ID 1052223229, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sibley Memorial Hospital Hospital, Washington, DC, CCN 090005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkackley1395129@direct.hopkinsmedicine.org

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.

• Johns Hopkins University

  • Medical Oncology Physician
  • Baltimore, MD
  • NPI 1902896970

  DC

  Medicare reassignment Care Compare group NPD
• Johns Hopkins University

  • Optometrist
  • Arlington, VA
  • NPI 1316750508
  NPD
• Johns Hopkins University

  • Radiation Oncology Physician
  • Baltimore, MD
  • NPI 1710106414
  NPD

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

• Lucy Webb Hayes National Training School for Deaconesses & Missionarie

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1366492977
  Care Compare affiliation

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1285241554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "202-537-4000",
            "fax_number": "410-500-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 LOUGHBORO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162633",
            "telephone_number": "202-537-4000",
            "fax_number": "202-537-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACKLEY",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180229",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "NP1039064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF NURSING",
            "identifier": "0024180229",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wondwossen Kabtamu
• Shewanesh Kabthymer
• Kara Elizabeth Kachejian, RN
• Kachikate & Lilly Healthcare Services LLC
• Peace Kachuchuru
• Payal S Kadakia, NP
• Vishal Dixit Kadakia, M.D.
• Anjana Kadakkal
• Mohammad Kadamany, M.D.
• Kadara Multi-Service Inc

• Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.