Individual provider Active NPI

Lisa Mackey

  • Counselor
  • Rochester, MN
National Provider Identifier
1609317502
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3069 Issued in MN
Practice address
1811 Greenview PL SW Ste 110
Rochester, MN 55902-4354
Phone
(507) 446-0431
NPI assigned
Mar 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3069 MN Primary

Addresses

Primary practice location

1811 Greenview PL SW Ste 110
Rochester, MN 55902-4354

Mailing address

2575 Harvest Lane NW
Owatonna, MN 55060

Other practice location 1

2575 Harvest Lane NW
Owatonna, MN 55060
Phone (507) 446-0431

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

LicenseStateTypeSpecialty
3069MNMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609317502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 HARVEST LANE NW",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "55060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 GREENVIEW PL SW STE 110",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024354",
            "telephone_number": "507-446-0431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2575 Harvest Lane NW",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "55060",
            "country_code": "US",
            "telephone_number": "507-446-0431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.