Individual provider Active NPI

Mackenzie Lynch

  • Family Nurse Practitioner
  • Jackson, MO
National Provider Identifier
1619775632
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025006360 Issued in MO
Practice address
2130 E Jackson Blvd
Jackson, MO 63755-2907
Phone
(573) 243-8408
NPI assigned
Mar 5, 2025
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025006360 MO Primary

Addresses

Primary practice location

2130 E Jackson Blvd
Jackson, MO 63755-2907

Mailing address

226 S Messmer St
Scott City, MO 63780-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20250422000728 MO Practitioner - Nurse Practitioner 6901321066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

2130 E Jackson Blvd
Saint Francis Clinic Jackson
Jackson, MO 63755-2907
Phone (573) 243-3115

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Apr 11, 2025 Accepting new patients
Saint Francis Medical Center CurrentSince Apr 11, 2025 Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Past Accepting new patients

Locations

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

2130 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-3115

Interoperability endpoints

  • Direct secure messaging: mlynch93541@surescripts.sfmc.net

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1619775632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S MESSMER ST",
            "city": "SCOTT CITY",
            "state": "MO",
            "postal_code": "637801101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552907",
            "telephone_number": "573-243-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025006360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MO

Sources for this page

Verify at the official NPI Registry.