Kakethia S. Mack, NURSE PRACTITIONER
NPI 1346748837ActiveIndividual· Nurse Practitioner, Family· Ellenwood, GA
Nurse Practitioner, Family (NURSE PRACTITIONER) in Ellenwood, Georgia, licensed in GA, with an NPI issued in January 2018.
Overview
| NPI | 1346748837 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NURSE PRACTITIONER |
| Sole proprietor | Yes |
| NPI issued | Jan 30, 2018 |
| Last updated in NPPES | Jul 2, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | RN154797 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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