NPIMap

Individual provider Active NPI

Mackenzie Kay Lamb, PA-C

  • Physician Assistant
  • McMinnville, OR
National Provider Identifier
1811360381
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA174877 Issued in OR
Practice address
2435 NE Cumulus Ave
McMinnville, OR 97128-8805
Phone
(503) 472-6161
NPI assigned
Nov 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA174877 OR Primary

Addresses

Primary practice location

2435 NE Cumulus Ave
McMinnville, OR 97128-8805

Mailing address

2435 NE Cumulus Ave
McMinnville, OR 97128-8805
Phone (503) 472-6161

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlamb798648@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422000357 OR Practitioner - Physician Assistant 4789983917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

4004 Kruse Way PL
Suite 300
Lake Oswego, OR 97035-2479
Phone (503) 216-1500

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince May 15, 2017 Accepting new patients
McMinnville Imaging Associates LLP Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1811360381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMB",
        "first_name": "MACKENZIE",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA174877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlamb798648@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4004 Kruse Way Pl Ste 300",
            "city": "Lake Oswego",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970352479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.