Patricia Rose Mack

Primary specialty

HomemakerTaxonomy code 376J00000X

Practice address

8259 State Route 88
Ravenna, OH 44266-9158

Phone

(330) 296-0322

Fax

(330) 296-0322

NPI assigned

Nov 4, 2020

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 identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1386245504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 STATE ROUTE 88",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442669158",
            "telephone_number": "330-296-0322",
            "fax_number": "330-296-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8259 STATE ROUTE 88",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442669158",
            "telephone_number": "330-296-0322",
            "fax_number": "330-296-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "PATRICIA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2084355",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ravenna",
            "affiliation": "N",
            "endpointDescription": "roseymack@aol.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8259 State Route 88",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442669158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ravenna",
            "affiliation": "N",
            "endpointDescription": "roseymack@aol.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8259 State Route 88",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442669158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ravenna",
            "affiliation": "N",
            "endpointDescription": "roseymack@aol.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8259 State Route 88",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442669158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rabecca Lydick
• Heaven Neveah Lytle
• Nasir Stewart Lytle
• M&J Medical Supply
• Angel Mack, SW-T
• Jeffery David Macmonigal
• Kelly Macmullin, LISW
• Carmela Macreno
• Karla Jeanne Madalin, MD
• Stacy Maddox

• Homemaker in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Homemaker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.