Individual provider Active NPI

Mackenzie Hoffman, DNP AGNP

  • Nurse Practitioner
  • Eden, NC
National Provider Identifier
1821641002
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011952 Issued in NC
Practice address
405 Thompson St
Eden, NC 27288-5045
Phone
(336) 627-4896
Fax
(336) 627-0139
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011952 NC Primary

Addresses

Primary practice location

405 Thompson St
Eden, NC 27288-5045

Mailing address

405 Thompson St
Eden, NC 27288-5045
Phone (336) 627-4896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220000822 NC Practitioner - Nurse Practitioner 1254722671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eden Internal Medicine PLLCGroup PAC ID 4183703945, 6 clinicians

Practice addresses (Care Compare)

405 Thompson St
Eden, NC 27288-5045
Phone 3366274896318

Hospital & facility affiliations

  • Unc Rockingham Hospital, Eden, NC, CCN 340060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eden Internal Medicine PLLC CurrentSince Sep 16, 2021 Accepting new patients

Locations

405 Thompson St
Eden, NC 27288
Phone (336) 627-4896

Organizations & group practices 1

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 1

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1821641002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 THOMPSON ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885045",
            "telephone_number": "336-627-4896",
            "fax_number": "336-627-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 THOMPSON ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885045",
            "telephone_number": "336-627-4896",
            "fax_number": "336-627-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MACKENZIE",
        "credential": "DNP AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

Verify at the official NPI Registry.