Active NPI
Sharol Diane Mackie, FNP
- Nurse Practitioner
- Redding, CA
National Provider Identifier
1750580544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 12909
- Practice address
- 1355 East St
Suite 200
Redding, CA 96001-0801 - Phone
- (530) 605-4260
- Fax
- (530) 605-4265
- NPI assigned
- Jul 12, 2007
- Last updated
- Sep 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 12909 | CA | Primary |
Addresses
Primary practice location
1355 East St
Suite 200
Redding, CA 96001-0801
Mailing address
1355 East St
Suite 200
Redding, CA 96001-0801
Phone (530) 605-4260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12909 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1750580544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 EAST ST",
"address_2": "SUITE 200",
"city": "REDDING",
"state": "CA",
"postal_code": "960010801",
"telephone_number": "530-605-4260",
"fax_number": "530-605-4265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 EAST ST",
"address_2": "SUITE 200",
"city": "REDDING",
"state": "CA",
"postal_code": "960010801",
"telephone_number": "530-605-4260",
"fax_number": "530-605-4265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIE",
"first_name": "SHAROL",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-12",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "12909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.