MARY KLACIK WEBSTER DO
NPI 1124762018
Student in an Organized Health Care Education/Training Program in Memphis, TN

Q: What is Mary Webster's NPI number?

The NPI number for Mary Webster is 1124762018. It was assigned to this individual provider in the NPPES registry on April 26, 2022. The provider is also known as Mary Susan Klacik Do.

Q: What is Mary Webster's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Webster was last updated on June 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2022PECOS Enrolled

920 MADISON AVE STE 447, MEMPHIS, TN 38103(901) 448-5814 Get Directions Write a Review

NPPES record last updated: June 22, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 22, 2025, Apr 26, 2022 (2 updates tracked since 2022).

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About Mary Klacik Webster Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY KLACIK WEBSTER DO (NPI 1124762018) is an individual student in an organized health care education/training program in Memphis, Tennessee and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124762018

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameMARY KLACIK WEBSTERCredential: DO

Location Address920 MADISON AVE STE 447Memphis, TN 38103-3438

Mailing Address920 Madison Ave Ste 447Memphis, TN 38103-3438 · (901) 448-5814

Phone(901) 448-5814

Sole ProprietorNo

Enumeration DateApril 26, 2022

Last NPPES UpdateJune 22, 20252 updates tracked since enumeration

NPPES CertifiedJune 22, 2025

✔ NPI 1124762018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

920 MADISON AVE STE 447, Memphis, TN 38103

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Other Names 1

Former Name (1)Mary Susan Klacik Do

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Klacik Webster Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID EDWARD ZIMMERHANZEL MD

Student in an Organized Health Care Education/Training Program