Phyllis Mackamul, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LN99200 Issued in MA

Practice address

12A Mount Vernon St
Worcester, MA 01605-3465

Phone

(239) 308-8831

NPI assigned

Feb 4, 2021

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1801488622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12A MOUNT VERNON ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053465",
            "telephone_number": "239-308-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12A MOUNT VERNON ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053465",
            "telephone_number": "239-308-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAMUL",
        "first_name": "PHYLLIS",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN99200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelida Machicote, MA
• Joseph James Machowski
• Deirdre Maciak
• Michell Macias
• Amy Mack, MD
• Emily Mackenzie
• Cassandra N. Mackey, MD
• Kaitlyn Mackey
• Linda J Mackey, LMHC
• W. Andrew Mackie Jr., PA-C

• Licensed Practical Nurse in Worcester, MA
• Providers in Worcester, MA by specialty
• Licensed Practical Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.