Matthew Scott Mackrell

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R0610 Issued in TX

Practice address

1500 S Main St
Fort Worth, TX 76104-4917

Phone

(817) 702-3431

NPI assigned

Mar 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmackrell355451@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment NPD
• Sandhills Emergency Physicians PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Pinehurst, NC
  • NPI 1003853409
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496361600000",
    "number": "1760876916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKRELL",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2017-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R0610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Enid Mackenzie
• Lindsey Mackey, CCC-SLP
• Zaquia Shenaethia Mackey, PA
• Hollin Taylor Macklin, RN, BSN
• Michael Macko, PT DPT OCS MTC
• Rowena J Maclin, D.O.
• Tony Allen Maclin, LPC
• Donald Macmullin, DC
• Hillary Erin Macneil, CPNP
• Anusha Amin Macnojia, MD

• Emergency Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.