Individual provider Active NPI

Mackenzie Nicole Swinehart

  • Gerontology Occupational Therapist
  • Newark, NY
National Provider Identifier
1821789900
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
Practice address
100 Sunset Dr
Newark, NY 14513-1068
Phone
(315) 332-2700
NPI assigned
May 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X Primary

Addresses

Primary practice location

100 Sunset Dr
Newark, NY 14513-1068

Mailing address

212 Brookside Dr
Waterloo, NY 13165-1838
Phone (315) 651-0542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1821789900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 BROOKSIDE DR",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651838",
            "telephone_number": "315-651-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SUNSET DR",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131068",
            "telephone_number": "315-332-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINEHART",
        "first_name": "MACKENZIE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.