Kathleen Theresa Mack, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP008049 Issued in PA

Practice address

1560 Garrett Rd
Upper Darby, PA 19082-4516

Phone

(610) 638-1076

Fax

(610) 638-1085

NPI assigned

Nov 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, DE2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Christiana Care Health Services Inc

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1760811681
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Pediatric Adolescent Medicine Physician
  • Chester, PA
  • NPI 1487001996
  NPD
• Christiana Care Health Services, Inc

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD
• Gurpreet Kochar MD PC

  • Specialist
  • Ridley Park, PA
  • NPI 1710080783
  NPD (past)
• Gurpreet Kochar MD-PC

  • Specialist
  • Drexel Hill, PA
  • NPI 1740582329
  NPD (past)

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

{
    "created_epoch": "1225584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1932352002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 GARRETT RD",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190824516",
            "telephone_number": "610-638-1076",
            "fax_number": "610-638-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 GARRETT RD",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190824516",
            "telephone_number": "610-638-1076",
            "fax_number": "610-638-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "KATHLEEN",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-02",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long Lane Discount Pharmacy LLC
• Bailey Ann Lotozo
• M & K'S Relying With Ease Services LLC
• M&I Homecare and Community Services
• Thanh Mach, DPT
• Magenta Home Care Services, Inc.
• Magnolia Wellness, LLC
• Main Line Medical Supplies Inc
• Make It Happen Phily Inc
• Make It Happen Phily Inc

• Family Nurse Practitioner in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.

Verify at the official NPI Registry.