MRS. KELLY S MACK (NPI# 1457471542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457471542 |
| Entity Type | Individual |
| Full Name | MRS. KELLY S MACK |
| Credential | APRN BC |
| Practice Address |
6001 Research Park Blvd Madison WI 53719 |
| Mailing Address |
7974 Uw Health Ct Middleton WI 53562-5531 |
| Practice Telephone | 6082323333 |
| Practice Fax Number | 6082319011 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2009-04-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2791033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578896460 | Kelly Mack | Speech-Language Pathologist | 2124 16th St, Boulder, CO 80302-4354 | 2009-09-10 |
| 1215184056 | Kelly Mack | Physical Therapist | 107 Holly Creek Dr, Irmo, SC 29063-8918 | 2008-08-23 |
| 1780702472 | Kelly Wade Mack | Dentist | 2200 Horseshoe Ln, Longview, TX 75605-5648 | 2007-03-27 |
| 1396813960 | Kelly Leigh Mack | Physician Assistant | 995 N. Prince Frederick Blvd, Suite 204, Prince Frederick, MD 20678 | 2006-12-01 |
| 1003468273 | Kelly Lynne Mack | Nurse Practitioner | 2215 Burdett Ave, Troy, NY 12180-2466 | 2019-07-09 |
| 1972933646 | Kelly Mack | Physical Therapy Assistant | 44480 W Honeycutt Rd, #106, Maricopa, AZ 85138-2903 | 2013-11-17 |
| 1164692455 | Kelly Jene Mack | Counselor | 3737 Portland Rd Ne, Salem, OR 97301-0311 | 2008-03-03 |
| 1982742888 | Kelly C Mack | Nurse Practitioner | 1800 Williams St, Suite 200, Denver, CO 80218-1234 | 2007-02-02 |
| 1245308899 | Kelly Anne Mack | Dental Hygienist | 55 E Loop Rd, Grove Dental Assoc Suite 201, Wheaton, IL 60187 | 2006-12-01 |
| Street Address |
6001 RESEARCH PARK BLVD |
| City | MADISON |
| State | WI |
| Zip Code | 53719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497747067 | Timmons H Hamrick IIi | Psychiatry & Neurology | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2005-08-18 |
| 1518427277 | Aisha I Rosh | Psychologist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2019-03-20 |
| 1144705567 | Elizabeth Gail Weitz | Nurse Practitioner | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2018-10-02 |
| 1538644018 | Melissa Heinemann | Psychologist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2018-10-01 |
| 1083192074 | Jessica Anne Umhoefer | Psychologist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2018-08-01 |
| 1003338864 | Sharon K. Finlayson | Nurse Practitioner | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2017-07-13 |
| 1467903849 | Brianne Mw Vandyke | Physical Therapist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2016-10-20 |
| 1205383049 | Katherine Elizabeth Schaumberg | Psychologist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2016-09-09 |
| 1164876777 | Jacob Ferris | Psychiatry & Neurology | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2016-04-20 |
| 1023496783 | Allison Marie Detloff | Psychologist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2015-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271801 | Jessica Seidel | Registered Nurse | 1015 Gammon Lane, Madison, WI 53719 | 2020-10-01 |
| 1376168989 | 360 Wellness LLC | Physical Therapist | 504 S Yellowstone Lane, Madison, WI 53719 | 2020-06-09 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 1285289587 | Clifton Leo Davis Jr. | Counselor | 6417 O Dana Rd #5, Madison, WI 53719 | 2019-08-05 |
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1689230211 | Brandy Georgecopeland | Marriage & Family Therapist | 6417 Odana Rd. Ste 5, Madison, WI 53719 | 2019-05-20 |
| 1275016826 | Kelsey Andersen | Physical Therapist | 504 S. Yellowstone Lane, Madison, WI 53719 | 2018-09-10 |
| 1740797190 | Catelyn Schwerke | Social Worker | 3848 Maple Grove Dr, Apt 307, Madison, WI 53719 | 2018-01-08 |
| 1922519008 | Mary Jane Cruz Delorme | Registered Nurse | 6831 Mader Dr. #210, #210, Madison, WI 53719 | 2017-10-17 |
| Find all providers in zip 53719 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235740556 | Lucille Elizabeth Nathwani | Nurse Practitioner | Uw Medical Foundation 600 Highland Ave, Madison, WI 53792-0001 | 2020-08-11 |
| 1770193419 | Madison Emergency Group, PC | Nurse Practitioner | 1740 Lions Club Rd, Madison, GA 30650-4762 | 2020-08-07 |
| 1376169920 | Brittany Linton | Nurse Practitioner | 149 Fountains Blvd, Madison, MS 39110-6344 | 2020-06-19 |
| 1811517402 | Lillian Teicher Branham | Nurse Practitioner | 382 Slaughter Rd, Madison, AL 35758-2008 | 2020-04-23 |
| 1275179509 | Claire E P Bergman | Nurse Practitioner | 20 S Park St Ste 360, Madison, WI 53715-1387 | 2019-11-21 |
| 1750923538 | Samuel Scott Mccullough IIi | Nurse Practitioner | 120 Fountains Blvd # 1000, Madison, MS 39110-6343 | 2019-10-12 |
| 1083266779 | Heather Hontzas | Nurse Practitioner | 159 Fountains Blvd Ste A, Madison, MS 39110-6344 | 2019-07-12 |
| 1114404118 | Allison Dyrek | Nurse Practitioner | 20 S Park St Ste 405, Madison, WI 53715-1378 | 2018-07-23 |
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1366962045 | Katherine Marie Domes | Nurse Practitioner | 5804 Halley Way, Madison, WI 53718-2934 | 2017-06-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.