Mary Jo M Mackinnon, FNP-C, ND

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN00581 Issued in RI

Practice address

8 Abbott Park PL
Providence, RI 02903-3703

Phone

(401) 598-1104

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1932225794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WOOD COVE DR",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166611",
            "telephone_number": "303-981-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 ABBOTT PARK PL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033703",
            "telephone_number": "401-598-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "MARY JO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "FNP-C, ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "259166",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN00581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mika Lorien Morgan Macinnis, PH.D.
• Khohlia Mack, DMD
• Megan Mack, LICSW
• Melanie Mack, PA-C
• Thomas Mack, LCSW
• Scott F Mackinnon, MD
• Diane M Macksoud, PT
• David B Maclean, MD
• Joanna Vaz Maclean, M.D.
• Cynthia Macleod, RN

• Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.