Mackinzie Lee, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904736 Issued in MS

Practice address

1700 University Blvd Ste 8
Jackson, MS 39204-3907

Phone

(601) 502-4245

NPI assigned

Jan 5, 2021

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• The Vaccination Station, LLC

  • Nursing Care Agency
  • Raymond, MS
  • NPI 1811572597
  NPD Authorized official

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1982292926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 SPRINGRIDGE RD",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391549492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY BLVD STE 8",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043907",
            "telephone_number": "601-502-4245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4985 Springridge Rd",
            "address_purpose": "LOCATION",
            "city": "Raymond",
            "state": "MS",
            "postal_code": "391549492",
            "country_code": "US",
            "telephone_number": "601-502-4245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MACKINZIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "886202",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Lee, MD
• Ellen C Lee
• Jacob Cole Lee, PA-C
• Jonathan Lee
• Lindsey Lee
• Manervia Lee
• Patrick Lee
• Sandra Jeanette Lee, MSW PCMHT (#3820)
• Scottye C Lee, DMD
• Stephen Bret Lee, CPO

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.