Staci Mackay-Mercer, CO

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

C062 Issued in GA

Practice address

129 Mirramont Lake Dr
Woodstock, GA 30189-8215

Phone

(770) 401-1408

NPI assigned

Feb 6, 2025

Last updated

Mar 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Staci Mackay Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Merciful O&P LLC

  • Prosthetic/Orthotic Supplier
  • Woodstock, GA
  • NPI 1497558472

  Orthotist

  NPD Authorized official

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1356155444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MIRRAMONT LAKE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898215",
            "telephone_number": "770-800-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 MIRRAMONT LAKE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898215",
            "telephone_number": "770-401-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAY-MERCER",
        "first_name": "STACI",
        "credential": "CO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "GA",
            "license": "C062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "MACKAY",
            "credential": "CO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Orthotist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Orthotist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.