Patricia McKie

Primary specialty

DentistTaxonomy code 122300000X

License

12012143A Issued in IN

Practice address

3204 Lancer St Ste a
Portage, IN 46368-4491

Phone

(219) 762-5506

NPI assigned

Jun 10, 2014

Last updated

Jan 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Maple City Dentistry, Inc

  • General Practice Dentistry
  • La Porte, IN
  • NPI 1922662204
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1447663190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 LANCER ST STE A",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684491",
            "telephone_number": "219-762-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 LANCER ST STE A",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684491",
            "telephone_number": "219-762-5506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Professional Ct",
            "address_purpose": "LOCATION",
            "city": "Hebron",
            "state": "IN",
            "postal_code": "463418948",
            "country_code": "US",
            "telephone_number": "219-996-7506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKIE",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22777",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-2608",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012143A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn M Matusz, COTA
• Luke McAuley, OT
• Michelle Lynn McBrayer, LCSW
• Ellen M McCue
• Jessica McElfresh
• Kaley McLendon
• Medical Associates of Nwi LLC (Manwi)
• Austre Berta Medina
• Suzanne N Meeks, RN, MSN, FNP-C
• Shaun Sadruddin Mehdi, DO

• Dentist in Portage, IN
• Providers in Portage, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.