Shimara Mackey

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1642 N Volusia Ave Ste 201
Orange City, FL 32763-3850

Phone

(386) 628-0295

Fax

(386) 243-4581

NPI assigned

Dec 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Jessup, Inc

  • Behavior Analyst
  • Orange City, FL
  • NPI 1922518489

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1639640485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 N VOLUSIA AVE STE 201",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327633850",
            "telephone_number": "386-628-0295",
            "fax_number": "386-243-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 N VOLUSIA AVE STE 201",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327633850",
            "telephone_number": "386-628-0295",
            "fax_number": "386-243-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "SHIMARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wei Lu, MD
• Cynthia Luciano, PA-C
• Ashraf A Luqman, MD
• Alexa Lynn Lynch
• Jennifer C Macdonald, ARNP
• Jatea Monet Maddox, PHARM. D.
• Keren Madriz
• Michael John Magee, M.D.
• Main Street Children'S Dentistry and Orthodontics of Orange City, P.a.
• Jarelin Lizeth Malagon Lara

• Behavior Technician in Orange City, FL
• Providers in Orange City, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.