NPI age
19 years
Enumerated 2007-01-10
● Active
Type 1 · Individual
Candra Lanette MacK, M.D.
MacK is 1 of 12 pediatrics providers in Covington and 1 of 2726 in Georgia.
Primary specialty
Pediatrics
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-03-07
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2726 active pediatrics providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
State licenses
2 states
Top 89% — 10% of peers are multi-state
Subspecialties
0
23% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Practice location
4152 Baker Street, Ne
Covington, GA 300141404
Mailing address
4152 Baker Street, Ne
Covington, GA 300141404
Specialties
-
Pediatrics PrimaryA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 061000 | MEDICAL LICENSE |
| 05 (GA) | 510091718A |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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