Individual provider Active NPI

Sarah Jewel McMackin, FNP-BC

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1639596349
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18576 Issued in TN
Practice address
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone
(423) 431-6561
Fax
(423) 431-5850
NPI assigned
Mar 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024184337 VA
Family Nurse Practitioner 363LF0000X 18576 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Johnson City, TN 37604-6035

Mailing address

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6561

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
I20140710001662 TN Practitioner - Nurse Practitioner 2264657014 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18576TNMDFamily Nurse Practitioner
0024184337VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Observation Services, PC CurrentSince Apr 1, 2017 Accepting new patients
Tri-Cities Regional Emergency Physicians, PC CurrentSince Apr 1, 2017 Accepting new patients

Locations

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-1000

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

Organizations & group practices 2

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": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1639596349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-6561",
            "fax_number": "423-431-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-6561",
            "fax_number": "423-431-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMACKIN",
        "first_name": "SARAH",
        "middle_name": "JEWEL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184337",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.