Individual provider Active NPI

Mani Vignesh Kannan

  • Student in an Organized Health Care Education/Training Program
  • Pontiac, MI
National Provider Identifier
1083406938
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
44405 Woodward Ave. Trinity Health Oakland
Graduate Medical Education Dept.
Pontiac, MI 48341
Phone
(248) 858-6233
Fax
(248) 858-3244
NPI assigned
May 19, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

44405 Woodward Ave. Trinity Health Oakland
Graduate Medical Education Dept.
Pontiac, MI 48341

Mailing address

44405 Woodward Ave. Trinity Health Oakland
Graduate Medical Education Dept.
Pontiac, MI 48341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250830000728 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2860993862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1083406938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE. TRINITY HEALTH OAKLAND",
            "address_2": "GRADUATE MEDICAL EDUCATION DEPT.",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "fax_number": "248-858-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE. TRINITY HEALTH OAKLAND",
            "address_2": "GRADUATE MEDICAL EDUCATION DEPT.",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-858-6233",
            "fax_number": "248-858-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNAN",
        "first_name": "MANI VIGNESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.