Individual provider Active NPI

Lea Marlys Mackinnon

  • Diagnostic Radiology Physician
  • Durham, NC
National Provider Identifier
1699154542
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2020-00318 Issued in NC
Practice address
2301 Erwin Road
Durham, NC 27710-3052
Phone
(919) 684-2711
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R75042 AZ
Diagnostic Radiology Physician 2085R0202X 2020-00318 NC Primary

Addresses

Primary practice location

2301 Erwin Road
Durham, NC 27710-3052

Mailing address

PO Box 63362
Charlotte, NC 28263-3362

Other practice location 1

1979 N Stoneview Pl
Boise, ID 83702-3052
Phone (650) 521-3316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621000942 ID Practitioner - Diagnostic Radiology 5890087738 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arizona College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

1979 N Stoneview PL
Boise, ID 83702-3052
Phone (919) 684-8111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
92.87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R75042AZMDDiagnostic Radiology Physician
2020-00318NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Radiology Group PLLC Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Weiser Valley Hospital District Diagnostic Radiology CurrentSince Jan 29, 2022 Accepting new patients
North Canyon Medical Center Inc. CurrentSince Jul 1, 2021 Accepting new patients
Weiser Valley Hospital District CurrentSince Jan 29, 2022 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223

703 S Americana Blvd
Boise, ID 83702
Phone (208) 706-6375

600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444

1000 E Park Blvd
Boise, ID 83712
Phone (208) 381-4100

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

3101 E State St
Eagle, ID 83616
Phone (208) 473-3100

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217

3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

Organizations & group practices 7

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 8

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1699154542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN ROAD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277103052",
            "telephone_number": "919-684-2711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1979 N Stoneview Pl",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837023052",
            "country_code": "US",
            "telephone_number": "650-521-3316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "LEA",
        "middle_name": "MARLYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "R75042",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2020-00318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.