Kwaifa Kary Mack, DNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP16612 Issued in CA

Practice address

1801 Westwind Dr
Bakersfield, CA 93301-3028

Phone

(661) 632-1800

Fax

(661) 632-1886

NPI assigned

Dec 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1447312202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WESTWIND DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013028",
            "telephone_number": "661-336-5300",
            "fax_number": "661-336-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 WESTWIND DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013028",
            "telephone_number": "661-632-1800",
            "fax_number": "661-632-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "KWAIFA",
        "middle_name": "KARY",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP16612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT11802F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rolando Macias, MD
• Rosenda Arias Macias, LICENSED VOCATIONAL
• Lilyan Maciel-Lopez
• Monica Maciel
• Angela Louise Mack, PHARMD
• Michael Anthony Mack, RADT-1
• Sabrina Mack
• Meagan O'Rourke Mackey, M.D.
• Shakila A Mackey
• Shaquia Mackey

• Nurse Practitioner in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.