Individual provider Active NPI

Joseph S Mackley, CRNA

  • Certified Registered Nurse Anesthetist
  • Fresno, CA
National Provider Identifier
1679503247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA2200 Issued in CA
Practice address
7152 N Sharon Ave
104
Fresno, CA 93720-3361
Phone
(559) 447-4898
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA2200 CA Primary

Addresses

Primary practice location

7152 N Sharon Ave
104
Fresno, CA 93720-3361

Mailing address

PO Box 3776
Pinedale, CA 93650-3776
Phone (559) 436-0871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051122000648 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496775280 Reassigns benefits to 2 organizations
Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2200CAMDOccupational Therapist
NA2200CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hypnos Anesthesia a Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Nov 11, 2024 Accepting new patients
Comprehensive Anesthesia, a California Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2018 Accepting new patients
Evexia Wellness Centers Inc Nurse Anesthetist, Certified Registered PastSince Nov 15, 2020 Accepting new patients

Locations

2139 E Beechwood Ave
Fresno, CA 93720
Phone (559) 322-6600

7152 N Sharon Ave
Ste 104
Fresno, CA 93720
Phone (559) 447-4898

1332 W Herndon Ave
Ste 102
Fresno, CA 93711
Phone (559) 440-9640

Organizations & group practices 3

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679503247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3776",
            "city": "PINEDALE",
            "state": "CA",
            "postal_code": "936503776",
            "telephone_number": "559-436-0871",
            "fax_number": "559-436-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7152 N SHARON AVE",
            "address_2": "104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203361",
            "telephone_number": "559-447-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLEY",
        "first_name": "JOSEPH",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA2200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.