Mac Anesthesia PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

MAC ANESTHESIA PLLC

Practice address

3353 N Gloster St
Tupelo, MS 38804-9735

Phone

(321) 443-7254

NPI assigned

Aug 25, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Mary A Cook, CRNA

Title

Owner/Member

Phone

(321) 443-7254

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1659984086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 JEAN JANE LN",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049113",
            "telephone_number": "321-443-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049735",
            "telephone_number": "321-443-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAC ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "321-443-7254",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Claire Lyle
• Chelsea Erin Lyle, FNP-C
• Logan Scott Lyle, FNP
• William O Lyle
• Forrest Lyon, MD
• Amber Snow Mackey, FNP-C
• David Phillip Mackey Jr., FNP-BC
• Matt Mackey, DC
• Lafadra Antonette Macklin, FNP-BC
• Magnolia Hospice, LLC

• Certified Registered Nurse Anesthetist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.