NPIMap

Individual provider Active NPI

Mark Donald Mackay, DO

  • Family Medicine Physician
  • Broadway, VA
National Provider Identifier
1427618735
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102207182 Issued in VA
Practice address
13892 Timber Way
Broadway, VA 22815-3332
Phone
(540) 901-0800
NPI assigned
Jun 18, 2019
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10067503 TX
Family Medicine Physician 207Q00000X 0102207182 VA Primary

Addresses

Primary practice location

13892 Timber Way
Broadway, VA 22815-3332

Mailing address

13892 Timber Way
Broadway, VA 22815-3332
Phone (540) 901-0800

Other practice location 1

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220614001953 VA Practitioner - Family Practice 6002295565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RMH Medical Group LLCGroup PAC ID 7618270729, 254 clinicians

Practice addresses (Care Compare)

13892 Timber Way
Broadway, VA 22815-3332
Phone (540) 901-0800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
BP10067503TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RMH Medical Group LLC CurrentSince Jul 11, 2022 Accepting new patients
RMH Medical Group LLC CurrentSince Jul 11, 2022 Accepting new patients
Rockingham Memorial Hospital Past Accepting new patients

Locations

13892 Timber Way
Broadway, VA 22815
Phone (540) 901-0800

136 W Elizabeth St
Ste 201
Harrisonburg, VA 22802
Phone (540) 564-5104

Interoperability endpoints

  • Direct secure messaging: mmackay764200@direct.sentara.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1427618735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13892 TIMBER WAY",
            "city": "BROADWAY",
            "state": "VA",
            "postal_code": "228153332",
            "telephone_number": "540-901-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13892 TIMBER WAY",
            "city": "BROADWAY",
            "state": "VA",
            "postal_code": "228153332",
            "telephone_number": "540-901-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Providence Dr",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767072261",
            "country_code": "US",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "MARK",
        "middle_name": "DONALD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10067503",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broadway, VA

Sources for this page

Verify at the official NPI Registry.