Stuart G Mack, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1815 Issued in KY

Practice address

215 N Allison Ave
Barbourville, KY 40906-1336

Phone

(606) 546-9287

Fax

(606) 546-9363

NPI assigned

Jun 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barbourville Family Health CenterGroup PAC ID 7416867387, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Corbin Hospital, Corbin, KY, CCN 180080

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Barbourville Family Health Center

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1275786071
  Medicare reassignment Care Compare group NPD (past)
• Barbourville Family Health Center

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1801872882
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Corbin, KY
  • NPI 1902865389
  Care Compare affiliation

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1982044616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N ALLISON AVE",
            "address_2": "PO BOX 1150",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-9287",
            "fax_number": "606-546-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N ALLISON AVE",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-9287",
            "fax_number": "606-546-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "STUART",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100255350",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA CARESOURCE",
            "identifier": "CS1631301477",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Aaron Lawson
• Angie Mossie Ledford, FNP-C
• Ashutosh S. Lohe, MD
• Rebecca Jean Long, M.A., CCC/SLP
• Lucas Family Medicine PLLC
• David T Malone, DPH
• Anitta Martin
• Donna Faye Martin
• Kaylee Mathis
• Lauren Mayton, PHARM.D.

• Physician Assistant in Barbourville, KY
• Providers in Barbourville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.