Individual provider Active NPI

Kristen Thigpen Mackens, PA-C, RD, LDN

  • Physician Assistant
  • Murfreesboro, TN
National Provider Identifier
1609694744
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6211 Issued in TN
Practice address
3325 Shores Rd
Murfreesboro, TN 37128-3616
Phone
(615) 867-8200
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6211 TN Primary

Addresses

Primary practice location

3325 Shores Rd
Murfreesboro, TN 37128-3616

Mailing address

PO Box 164
Rockvale, TN 37153-0164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20250102002015 TN Practitioner - Physician Assistant 5597292524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murfreesboro Medical Clinic, P.a.Group PAC ID 4789589227, 176 clinicians

Practice addresses (Care Compare)

1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone (615) 867-7925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6211TNMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: kristenmackens@mmcsc.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1609694744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 164",
            "city": "ROCKVALE",
            "state": "TN",
            "postal_code": "371530164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 SHORES RD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371283616",
            "telephone_number": "615-867-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENS",
        "first_name": "KRISTEN",
        "middle_name": "THIGPEN",
        "credential": "PA-C, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.