Individual provider Active NPI

Jason Machalicky, M.D.

  • Psychiatry Physician
  • Raleigh, NC
National Provider Identifier
1912110107
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200601823 Issued in NC
Practice address
901 Jones Franklin Rd
Raleigh, NC 27606-5441
Phone
(919) 852-5265
Fax
(919) 852-5267
NPI assigned
May 7, 2007
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 200601823 NC Primary

Addresses

Primary practice location

901 Jones Franklin Rd
Raleigh, NC 27606-5441

Mailing address

284 Executive Park Dr
Ste 100
Concord, NC 28025-1831
Phone (704) 939-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address integratedcare@direct.daymarkrecovery.nextgenshare.com Direct Daymark Recovery Services Inc

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080717000545 NC Practitioner - Psychiatry 3870666258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200601823NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Psychiatry CurrentSince Jan 10, 2010 Accepting new patients
Daymark Recovery Services Inc Psychiatry Past Accepting new patients
Daymark Recovery Services Inc Psychiatry Past Accepting new patients

Locations

943 W Andrews Ave
Ste H
Henderson, NC 27536
Phone (252) 433-0061

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

1400 Willow Ln
North Wilkesboro, NC 28659
Phone (336) 667-5151

205 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-2040

121 E Elwood Ave
Raeford, NC 28376
Phone (910) 875-8156

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

130 Carbonton Rd
Sanford, NC 27330
Phone (919) 774-6521

704 Old Lilesville Rd
Wadesboro, NC 28170
Phone (704) 694-6588

Interoperability endpoints

  • Direct secure messaging: jason.machalicky.p1@direct.daymarkrecovery.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1912110107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "address_2": "STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251831",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 JONES FRANKLIN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276065441",
            "telephone_number": "919-852-5265",
            "fax_number": "919-852-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHALICKY",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200601823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "integratedcare@direct.daymarkrecovery.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Daymark Recovery Services Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "284 Executive Park Dr",
            "address_2": "Suite 100",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.