Individual provider Active NPI

Jennifer L Mackley, APRN, FNP-C

  • Family Nurse Practitioner
  • Colby, KS
National Provider Identifier
1922778331
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-80538 Issued in KS
Practice address
310 E College Dr
Colby, KS 67701-3716
Phone
(785) 462-6184
Fax
(785) 460-1490
NPI assigned
Sep 16, 2021
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-80538 KS Primary

Addresses

Primary practice location

310 E College Dr
Colby, KS 67701-3716

Mailing address

310 E College Dr
Colby, KS 67701-3716
Phone (785) 462-6184

Other practice location 1

100 E College Dr
Colby, KS 67701-3799
Phone (785) 462-7511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20211006001653 KS Practitioner - Nurse Practitioner 1254739212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Medical Center IncGroup PAC ID 8729996467, 30 clinicians

Practice addresses (Care Compare)

100 E College Dr
Colby, KS 67701-3702

100 E College Dr
Colby, KS 67701-3799
Phone (785) 462-7511

310 E College Dr
Colby, KS 67701-3716

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-80538KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Medical Center, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Citizens Medical Center Inc CurrentSince Sep 20, 2021 Accepting new patients
Citizens Medical Center, Inc Current Accepting new patients

Locations

100 E College Dr
Colby, KS 67701
Phone (785) 462-7511

310 E College Dr
Colby, KS 67701
Phone (785) 462-6184

Interoperability endpoints

  • Direct secure messaging: jmackley661368@direct.ochin.org

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.

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1922778331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E COLLEGE DR",
            "city": "COLBY",
            "state": "KS",
            "postal_code": "677013716",
            "telephone_number": "785-462-6184",
            "fax_number": "785-460-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E COLLEGE DR",
            "city": "COLBY",
            "state": "KS",
            "postal_code": "677013716",
            "telephone_number": "785-462-6184",
            "fax_number": "785-460-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E College Dr",
            "address_purpose": "LOCATION",
            "city": "Colby",
            "state": "KS",
            "postal_code": "677013799",
            "country_code": "US",
            "telephone_number": "785-462-7511",
            "fax_number": "785-460-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKLEY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-80538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colby, KS

Sources for this page

Verify at the official NPI Registry.