Macky Enterprises P.C.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

61299 Issued in GA

Legal business name

MACKY ENTERPRISES P.C.

Practice address

5380 Peachtree Industrial Blvd
Ste 150
Norcross, GA 30071-4713

Phone

(770) 864-7788

Fax

(770) 446-1808

NPI assigned

Feb 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Shellon A McAllister-Brooks, M.D.

Title

Owner

Phone

(770) 864-7788

Specialties & licenses 1

Addresses

Other names 1

• Norcross Pain Management Clinic Doing business as

Tax ID family

Macky Enterprises PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Macky Enterprises P.C.

  • Primary Care Clinic/Center
  • Norcross, GA
  • NPI 1396013322
  NPD tax ID

Locations

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1386940419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "STE 150",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714713",
            "telephone_number": "770-864-7788",
            "fax_number": "770-446-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "STE 150",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714713",
            "telephone_number": "770-864-7788",
            "fax_number": "770-446-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKY ENTERPRISES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER-BROOKS",
        "authorized_official_first_name": "SHELLON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-864-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "61299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norcross Pain Management Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Judith Grace Lutumba
• Luxottica of America Inc.
• Melany Eden Lykke, NP
• Alexandra Lee Macalle, NP
• Laura Machado, LAPC
• Macky Enterprises P.C.
• Macky Enterprises PC
• Macs LTC Pharmacy Georgia LLC
• Haricharanteja Madduri
• Magnolia Medical Clinic, P.C.

• Pain Medicine Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.