Individual provider Active NPI

Van Mac

  • Infectious Diseases Pharmacist
  • Atlanta, GA
National Provider Identifier
1679420582
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Diseases PharmacistTaxonomy code 1835I0206X
License
RPH024620 Issued in GA
Practice address
341 Ponce de Leon Ave NE
Atlanta, GA 30308-2012
Phone
(404) 616-1000
NPI assigned
Mar 11, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Diseases Pharmacist 1835I0206X RPH024620 GA Primary

Addresses

Primary practice location

341 Ponce de Leon Ave NE
Atlanta, GA 30308-2012

Mailing address

225 Wembley Cir
Atlanta, GA 30328-6758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RPH024620GAMDMedical license number

NPI Registry JSON

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1679420582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WEMBLEY CIR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303286758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 PONCE DE LEON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082012",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "VAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835I0206X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Infectious Diseases",
            "state": "GA",
            "license": "RPH024620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.