Individual provider Active NPI

Mackenzie Breanne Wills

  • Occupational Therapist
  • Papillion, NE
National Provider Identifier
1760135438
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2595 Issued in NE
Practice address
701 Pinnacle Dr
Papillion, NE 68046-6224
Phone
(402) 505-7989
NPI assigned
Feb 1, 2022
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2595 NE Primary

Addresses

Primary practice location

701 Pinnacle Dr
Papillion, NE 68046-6224

Mailing address

701 Pinnacle Dr
Papillion, NE 68046-6224
Phone (402) 505-7989

Other names 1

  • Mackenzie Zach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613000282 NE Practitioner - Occupational Therapist in Private Practice 8820454036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Medical Group PCGroup PAC ID 6507137130, 13 clinicians

Practice addresses (Care Compare)

701 Pinnacle Dr
Suite 105
Papillion, NE 68046-6228
Phone (402) 505-7989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2595NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Well Mama, LLC Occupational Therapist Current Accepting new patients
Multicare Medical Group PC CurrentSince May 20, 2025 Accepting new patients

Locations

701 Pinnacle Dr
Ste 103
Papillion, NE 68046

701 Pinnacle Dr
Ste 105
Papillion, NE 68046
Phone (402) 505-7989

Organizations & group practices 2

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": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1760135438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PINNACLE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466224",
            "telephone_number": "402-505-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PINNACLE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466224",
            "telephone_number": "402-505-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "MACKENZIE",
        "middle_name": "BREANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "ZACH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.