Eric Nicholas Mack, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

433776 Issued in TX

Practice address

6160 Tutt Blvd
Colorado Springs, CO 80923-3500

Phone

(719) 540-2150

NPI assigned

Feb 26, 2020

Last updated

Feb 26, 2020By the provider in NPPES

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1639703812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 WINDING WAY CT",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752872767",
            "telephone_number": "802-558-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 TUTT BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233500",
            "telephone_number": "719-540-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ERIC",
        "middle_name": "NICHOLAS",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "433776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndsey Maciejewski
• Hayley Maciel
• Chamisa Macindoe, D.O.
• Emily R Macindoe, MSW, LCSW
• Anna Marie Mack, FNP-C
• Erin Mack
• Hillary Mack, DO
• Jade Lindsey Mack, LMFT
• Leah Mack, DPT
• Joshua Mackay, RBT

• Pediatric Occupational Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Pediatric Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.