Individual provider Active NPI

Timothy Wray Mackey, D.O.

  • Internal Medicine Physician
  • Key West, FL
National Provider Identifier
1730235797
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS9185 Issued in FL
Practice address
540 Truman Ave
Key West, FL 33040-3141
Phone
(305) 296-4399
NPI assigned
Jan 25, 2007
Last updated
Jul 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS9185 FL Primary
Internal Medicine Physician 207R00000X 34.008213 OH
Internal Medicine Physician 207R00000X 20A 9382 CA

Addresses

Primary practice location

540 Truman Ave
Key West, FL 33040-3141

Mailing address

540 Truman Ave
Key West, FL 33040-3141
Phone (305) 296-4399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050317000292 FL Practitioner - Family PracticePractitioner - General Practice 7618922188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 9382CAMDInternal Medicine Physician
34.008213OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vitality Medical Group, LLC Past Accepting new patients
Jessica J Wilson Chan D O PA PastSince Nov 3, 2019 Accepting new patients
Suncoast Total Healthcare LLC Past Accepting new patients
Physical Medicine Center PastSince Jun 23, 2013 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1730235797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 TRUMAN AVE",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330403141",
            "telephone_number": "305-296-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 TRUMAN AVE",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330403141",
            "telephone_number": "305-296-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "TIMOTHY",
        "middle_name": "WRAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS9185",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.008213",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A 9382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

Verify at the official NPI Registry.