Kippy Macklin

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61298980 Issued in WA

Practice address

1675 Winter St NE
Salem, OR 97301-7152

Phone

(503) 585-0351

NPI assigned

May 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fandm Healthcare, LLCGroup PAC ID 8628462983, 30 clinicians

Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kippy.macklin.1@28621.direct.athenahealth.com

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.

• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Eugene, OR
  • NPI 1316717747
  Medicare reassignment Care Compare group NPD
• F&M Healthcare, LLC

  • Internal Medicine Physician
  • University Place, WA
  • NPI 1861145120
  Medicare reassignment Care Compare group NPD
• New Perspectives Center for Counseling & Therapy

  • Mental Health Counselor
  • Salem, OR
  • NPI 1063462281
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Beaverton, OR
  • NPI 1225890460
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Seattle, WA
  • NPI 1114797545
  NPD (past)

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

{
    "created_epoch": "1653177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1881332781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S WAPAK RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458079404",
            "telephone_number": "419-234-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WINTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017152",
            "telephone_number": "503-585-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "KIPPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10020345",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61298980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Jene Mack, BS, CADCI
• Launa Carina Mack, DENTAL ASSISTANT
• Heather A Mackay, M.D.
• Chelsea Mackey
• Marissa Mackey, LMFT
• Karen J Macleod, COTA
• Molly Macmorris-Adix, CNM
• Nancy Macmorris-Adix, CNM
• Ladonna Macomber, LPC CCMHC
• Sean Patrick Madden

• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.