Active NPI
Dawn Macke
- Family Nurse Practitioner
- Sidney, OH
National Provider Identifier
1336512672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 18370-NP
- Practice address
- 1025 Fair Rd
Sidney, OH 45365-8947 - Phone
- (937) 492-1352
- Fax
- (937) 492-1353
- NPI assigned
- Nov 9, 2015
- Last updated
- Oct 14, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 18370-NP | OH | Primary |
Addresses
Primary practice location
1025 Fair Rd
Sidney, OH 45365-8947
Mailing address
1025 Fair Rd
Sidney, OH 45365-8947
Phone (937) 492-1352
Other practice location 1
665 E Hoewisher Rd
Sidney, OH 45365-1859
Phone (937) 658-4894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0149766 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | dmacke574721@direct.ketteringhealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1025 Fair Rd
Sidney, OH 45365-8947
Phone (937) 492-1352
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18370-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Macke Family Practice LLC | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
1025 Fair Rd
Sidney, OH 45365
Phone (937) 492-1352
322 2nd Ave
Sidney, OH 45365
Phone (937) 492-9128
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JDIICD/Endpoint/JDIICD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Sidney, OH
- NPI 1730816810
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kettering Health Troy
- General Acute Care Hospital
- Troy, OH
- NPI 1023587045
-
dba Wilson Health
- General Acute Care Hospital
- Sidney, OH
- NPI 1639174204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1336512672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 FAIR RD",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453658947",
"telephone_number": "937-492-1352",
"fax_number": "937-492-1353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 FAIR RD",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453658947",
"telephone_number": "937-492-1352",
"fax_number": "937-492-1353"
}
],
"practiceLocations": [
{
"address_1": "665 E Hoewisher Rd",
"address_purpose": "LOCATION",
"city": "Sidney",
"state": "OH",
"postal_code": "453651859",
"country_code": "US",
"telephone_number": "937-658-4894",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACKE",
"first_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-09",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "18370-NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0149766",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1103 Fairington Dr Ste 100",
"city": "Sidney",
"state": "OH",
"country_code": "US",
"postal_code": "453658130",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dmacke574721@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "1103 Fairington Dr Ste 100",
"city": "Sidney",
"state": "OH",
"country_code": "US",
"postal_code": "453658130",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sidney, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.