NPIMap

Organization Active NPI

Macky Enterprises P.C.

  • Primary Care Clinic/Center
  • Norcross, GA
National Provider Identifier
1396013322
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
61299 Issued in GA
Legal business name
MACKY ENTERPRISES P.C.
Practice address
5380 Peachtree Industrial Blvd
Ste 140
Norcross, GA 30071-4713
Phone
(770) 446-1818
Fax
(770) 446-1808
NPI assigned
Dec 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Authorized official

Name
Dr. Shellon Angela McAllister, M.D.
Title
Owner
Phone
(770) 446-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 61299 GA Primary

Addresses

Primary practice location

5380 Peachtree Industrial Blvd
Ste 140
Norcross, GA 30071-4713

Mailing address

5380 Peachtree Industrial Blvd
Ste 140
Norcross, GA 30071-4713
Phone (770) 446-1818

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1396013322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "STE 140",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714713",
            "telephone_number": "770-446-1818",
            "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 140",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714713",
            "telephone_number": "770-446-1818",
            "fax_number": "770-446-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKY ENTERPRISES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER",
        "authorized_official_first_name": "SHELLON",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-446-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "61299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.