JODY MACK PA NPI 1760663140

NPI Information

NPI: 1760663140
Provider Name: JODY MACK, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
947 S 5TH ST
MONTROSE, CO
ZIP 81401
Phone: (970) 249-2421
Get Directions

Jody Mack, PA is a medical physician assistant in Montrose, CO. Jody Mack, PA NPI is 1760663140. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

947 S 5TH ST
MONTROSE, CO
ZIP 81401-716
Phone: (970) 249-2421
Fax: (970) 249-1203

The enumeration date for this NPI number is 11/14/2007 and was last updated on 3/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		2457	COLORADO	No
2	363AM0700X	Physician Assistant	Medical	MED-PAC-LIC-61430	MONTANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	67538746	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »