Active NPI
Laura L. Mackie, M.D.
- Obstetrics & Gynecology Physician
- Oklahoma City, OK
National Provider Identifier
1396764221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 12274
- Practice address
- 11200 N Portland Ave
Oklahoma City, OK 73120-5045 - Phone
- (405) 936-1000
- Fax
- (405) 936-1001
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 12274 | OK | Primary |
Addresses
Primary practice location
11200 N Portland Ave
Oklahoma City, OK 73120-5045
Mailing address
11200 N Portland Ave
2ND FL
Oklahoma City, OK 73120-5045
Phone (405) 936-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100111900A | Medicaid | OK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12274 | OK | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1396764221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11200 N PORTLAND AVE",
"address_2": "2ND FL",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731205045",
"telephone_number": "405-936-1000",
"fax_number": "405-936-1001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 N PORTLAND AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731205045",
"telephone_number": "405-936-1000",
"fax_number": "405-936-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIE",
"first_name": "LAURA",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OK",
"license": "12274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100111900A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.