Active NPI
Mackenzie Richards
- Family Nurse Practitioner
- Malden, MA
National Provider Identifier
1467061218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN2311122
- Practice address
- 473 Eastern Ave
Malden, MA 02148-4201 - Phone
- (518) 651-5745
- NPI assigned
- Jul 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2311122 | MA | |
| Family Nurse Practitioner | 363LF0000X | RN2311122 | MA | Primary |
Addresses
Primary practice location
473 Eastern Ave
Malden, MA 02148-4201
Mailing address
25 Charlton St Apt 709
Everett, MA 02149-2478
Phone (518) 651-5745
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2311122 | MA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1467061218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CHARLTON ST APT 709",
"city": "EVERETT",
"state": "MA",
"postal_code": "021492478",
"telephone_number": "518-651-5745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "473 EASTERN AVE",
"city": "MALDEN",
"state": "MA",
"postal_code": "021484201",
"telephone_number": "518-651-5745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "MACKENZIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-28",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2311122",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN2311122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.