Active NPI
Michele Mackie Davis, PHYSICIAN ASSISTANT
- Physician Assistant
- Irving, TX
National Provider Identifier
1881796548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 04511
- Practice address
- 2000 Esters Rd
Ste 140
Irving, TX 75061-9531 - Phone
- (469) 212-1399
- Fax
- (469) 212-1399
- NPI assigned
- Sep 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 04511 | TX | Primary |
Addresses
Primary practice location
2000 Esters Rd
Ste 140
Irving, TX 75061-9531
Mailing address
PO Box 693
Spearman, TX 79081-0693
Phone (806) 886-3226
Other names 1
- Dana Michele Mackie
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070620000304 | TX | Practitioner - Physician Assistant | 9436256633 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 04511 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1881796548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 693",
"city": "SPEARMAN",
"state": "TX",
"postal_code": "790810693",
"telephone_number": "806-886-3226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 ESTERS RD",
"address_2": "STE 140",
"city": "IRVING",
"state": "TX",
"postal_code": "750619531",
"telephone_number": "469-212-1399",
"fax_number": "469-212-1399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHELE",
"middle_name": "MACKIE",
"name_prefix": "Mrs.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA 04511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DANA",
"last_name": "MACKIE",
"middle_name": "MICHELE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.