Active NPI
Jeffrey C Mackey, DC
- Orthopedic Chiropractor
- Madison, WI
National Provider Identifier
1316939119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 1576
- Practice address
- 3205 E Washington Ave
Madison, WI 53704-4332 - Phone
- (608) 249-7657
- Fax
- (608) 249-7728
- NPI assigned
- Aug 17, 2005
- 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 |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 1576 | WI | Primary |
Addresses
Primary practice location
3205 E Washington Ave
Madison, WI 53704-4332
Mailing address
3205 E Washington Ave
Madison, WI 53704-4332
Phone (608) 249-7657
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38764300 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1576 | WI | MD | Clinical Pathology/Laboratory Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1316939119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 E WASHINGTON AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537044332",
"telephone_number": "608-249-7657",
"fax_number": "608-249-7728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3205 E WASHINGTON AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537044332",
"telephone_number": "608-249-7657",
"fax_number": "608-249-7728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKEY",
"first_name": "JEFFREY",
"middle_name": "C",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-17",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "WI",
"license": "1576",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38764300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.