Macke Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MACKE FAMILY PRACTICE LLC

Practice address

1025 Fair Rd
Sidney, OH 45365-8947

Phone

(937) 492-1352

Fax

(937) 492-1353

NPI assigned

Aug 8, 2022

Organization subpart

No

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

Authorized official

Name

Dawn Diane Macke, APRN-CNPNPI 1336512672

Title

Nurse Practitioner

Phone

(937) 492-1352

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dawn Macke

  • Family Nurse Practitioner
  • Sidney, OH
  • NPI 1336512672
  Medicare reassignment Care Compare group NPD Authorized official
• Erica M Moses, CNP

  • Nurse Practitioner
  • Lima, OH
  • NPI 1700373990

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Rachelle J Cook, LSW

  • Mental Health Counselor
  • Sidney, OH
  • NPI 1316585193
  NPD (past)

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1730816810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 FAIR RD",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658947",
            "telephone_number": "937-492-1352",
            "fax_number": "937-492-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 FAIR RD",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658947",
            "telephone_number": "937-492-1352",
            "fax_number": "937-492-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "MACKE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "937-492-1352",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Long
• Kara K Long
• Jacob Andrew Luthman
• Annette Kay Lynch, RN
• M David Rhee MD Inc
• Dawn Macke
• Stacey Mahan
• Kimberly A Maltinsky, DPT
• Jessica R. Mangen
• Timothy A. Mangen

• Family Medicine Physician in Sidney, OH
• Providers in Sidney, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.