Mackenzie Catherine Martin

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045342-01 Issued in NY

Practice address

65 Prospect Ave
Hudson, NY 12534-2907

Phone

(518) 828-3890

NPI assigned

Sep 25, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nysarc Inc. Columbia County Chapter

  • Voluntary or Charitable Agency
  • Hudson, NY
  • NPI 1548563950
  NPD (past)

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1811548423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 ROUTE 67",
            "city": "EAST DURHAM",
            "state": "NY",
            "postal_code": "124231228",
            "telephone_number": "518-956-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PROSPECT AVE",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342907",
            "telephone_number": "518-828-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MACKENZIE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045342-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mack.kiefer@gmail.com",
            "affiliation": "N",
            "address_1": "65 Prospect Ave",
            "city": "Hudson",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125342907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal Blue Marks, L.AC.
• Paul Marks, L.AC.
• Peter Marotta, RN
• Kathryn Olivia Marrinan, LMSW
• Gail Maureen Marshall Walker, M.S., CCC-SLP
• Martins Foods of South Burlington LLC
• John F Mathews, M.D.
• Steven J Maxwell, D.O.
• Chelsea Lynn Mayo
• Tanya D Mays, M. D.

• Physical Therapist in Hudson, NY
• Providers in Hudson, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.