Individual provider Active NPI

Mackie D Sheckfee, DPT

  • Physical Therapist
  • Derby, CT
National Provider Identifier
1407089071
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008604 Issued in CT
Practice address
102 Hawthorne Ave
Derby, CT 06418-1142
Phone
(203) 231-0610
NPI assigned
Aug 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008604 CT Primary

Addresses

Primary practice location

102 Hawthorne Ave
Derby, CT 06418-1142

Mailing address

102 Hawthorne Ave
Derby, CT 06418-1142
Phone (203) 213-0610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091013000146 CT Practitioner - Physical Therapist in Private Practice 5799821351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT CT, LLCGroup PAC ID 8820235575, 76 clinicians

Practice addresses (Care Compare)

Southbury, CT 06488
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008604CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT CT, LLC Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients
Montowese Chiropractic Center LLC Past Accepting new patients
Quinnipiac Physical Therapy & Sports Medicine PC Physical Therapist PastSince Oct 1, 2012 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272844800000",
    "number": "1407089071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HAWTHORNE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181142",
            "telephone_number": "203-213-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HAWTHORNE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181142",
            "telephone_number": "203-231-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHECKFEE",
        "first_name": "MACKIE",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-31",
        "last_updated": "2010-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.