Mackenzie Erin Manley, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13826 Issued in GA

Practice address

1269 Wellbrook Cir NE
Conyers, GA 30012-3873

Phone

(770) 922-0505

Fax

(678) 625-5137

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Aga Professional Services, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1063799120
  Medicare reassignment
• Aga, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1124064118
  Medicare reassignment

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1730731266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123873",
            "telephone_number": "770-922-0505",
            "fax_number": "678-625-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1269 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123873",
            "telephone_number": "770-922-0505",
            "fax_number": "678-625-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "MACKENZIE",
        "middle_name": "ERIN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Maher
• William Bernard Mahoney, M.D.
• Mak Anesthesia Westside LLC
• Noah Beech Malone, CAA
• Quindel Malone, RBT
• Michael Joseph Manning, M.D.
• Kelly Marchman, RBT
• Margaret Gibson Ellison, LPC LLC
• Lisa Ann Maria, RCP
• Maribill Behavioral Health Services, LLC

• Physician Assistant in Conyers, GA
• Providers in Conyers, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.