Healthcare Provider Details

I. General information

NPI: 1659258143
Provider Name (Legal Business Name): MADISON MACKENZIE RAPIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 VOGT CT S
POWELL OH
43065-7416
US

IV. Provider business mailing address

507 VOGT CT S
POWELL OH
43065-7416
US

V. Phone/Fax

Practice location:
  • Phone: 614-800-2721
  • Fax:
Mailing address:
  • Phone: 614-800-2721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009816RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: