NPI age
4 years
Enumerated 2021-09-06
● Active
Type 1 · Individual
Kellie MacK, ATC
MacK is 1 of 5 specialist/technologist providers in Vidalia and 1 of 1405 in Georgia.
Primary specialty
Specialist/Technologist
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2021-09-06
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1405 active specialist/technologist providers in Georgia.
NPI age
4 years
↓ 5 yr below median (9 yr)
State licenses
1 state
4% of peers hold multiple states
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2021 → 2026
2021-09Enumerated in NPPES
2021
2026
Where they practice
Practice location
709 Allen Dr
Vidalia, GA 304746348
Mailing address
709 Allen Dr
Vidalia, GA 304746348
Specialties
-
Specialist/Technologist PrimaryAthletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently,...
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 →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.