Individual provider Active NPI

Lauren Rae Mackie, CNP

  • Family Nurse Practitioner
  • Canton, OH
National Provider Identifier
1689951014
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.12806-NP Issued in OH
Practice address
2600 6TH St SW
Canton, OH 44710-1702
Phone
(330) 363-6281
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.12806-NP OH Primary

Addresses

Primary practice location

2600 6TH St SW
Canton, OH 44710-1702

Mailing address

6133 Slavin Cir NW
Canal Fulton, OH 44614-8227
Phone (330) 704-4453

Other names 1

  • Lauren Rae Denczak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220719000220 OH Practitioner - Nurse Practitioner 3678855947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Physician Professional CorporationGroup PAC ID 2668406059, 143 clinicians

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 454-8076

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
77.5
Promoting interoperability
99
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.12806-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Physician Professional Corporation CurrentSince Apr 8, 2022 Accepting new patients
Aultman Hospital Current Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 6th St SW
Ste A2710
Canton, OH 44710
Phone (330) 429-5656

Interoperability endpoints

  • Direct secure messaging: lauren.mackie@direct.aultman.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1689951014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6133 SLAVIN CIR NW",
            "city": "CANAL FULTON",
            "state": "OH",
            "postal_code": "446148227",
            "telephone_number": "330-704-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "LAUREN",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.12806-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "DENCZAK",
            "middle_name": "RAE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.