Macky Enterprises PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

061299 Issued in GA

Legal business name

MACKY ENTERPRISES PC

Practice address

5380 Peachtree Industrial Blvd
140
Norcross, GA 30071-4713

Phone

(770) 446-1818

Fax

(770) 446-1808

NPI assigned

Oct 6, 2009

Organization subpart

No

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

Authorized official

Name

Shellon McAllister-Brooks, MD

Title

Owner

Phone

(770) 446-1818

Specialties & licenses 1

Addresses

Other names 1

• Peachtree Childrens Clinic Doing business as

Locations

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1821323072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "140",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714713",
            "telephone_number": "770-446-1818",
            "fax_number": "770-446-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "140",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714713",
            "telephone_number": "770-446-1818",
            "fax_number": "770-446-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKY ENTERPRISES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER-BROOKS",
        "authorized_official_first_name": "SHELLON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-446-1818",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "061299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Childrens Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melany Eden Lykke, NP
• Alexandra Lee Macalle, NP
• Laura Machado, LAPC
• Macky Enterprises P.C.
• Macky Enterprises P.C.
• Macs LTC Pharmacy Georgia LLC
• Haricharanteja Madduri
• Magnolia Medical Clinic, P.C.
• Cortney Jo Maholtz, CCC-SLP
• Majl Diagnostic Laboratories LLC

• Pediatrics Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.