Individual provider Active NPI

Mackenzie Lauren Mullenix, PHARMD

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1780931402
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13803 Issued in SC
Practice address
9 Piedmont Ctr NE
BLDG 10, Suite 412
Atlanta, GA 30305-1733
Phone
(770) 514-5451
NPI assigned
Aug 13, 2012
Last updated
Aug 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13803 SC Primary
Pharmacist 183500000X 027400 GA

Addresses

Primary practice location

9 Piedmont Ctr NE
BLDG 10, Suite 412
Atlanta, GA 30305-1733

Mailing address

207 Treyburn Cir
Irmo, SC 29063-8001
Phone (803) 749-0003

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
027400GAMDPharmacist
13803SCMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1780931402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 TREYBURN CIR",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290638001",
            "telephone_number": "803-749-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PIEDMONT CTR NE",
            "address_2": "BLDG 10, SUITE 412",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051733",
            "telephone_number": "770-514-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENIX",
        "first_name": "MACKENZIE",
        "middle_name": "LAUREN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "13803",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "027400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.