Individual provider Active NPI

Audrey Macklin

  • Physical Therapy Assistant
  • Mobile, AL
National Provider Identifier
1356081558
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA1365 Issued in MS
Practice address
61 Acacia St
Mobile, AL 36607-2610
Phone
(251) 654-2200
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1365 MS Primary

Addresses

Primary practice location

61 Acacia St
Mobile, AL 36607-2610

Mailing address

61 Acacia St
Mobile, AL 36607-2610
Phone (251) 654-2200

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA1365MSMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1356081558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 ACACIA ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072610",
            "telephone_number": "251-654-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 ACACIA ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072610",
            "telephone_number": "251-654-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "AUDREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.