Faith A. Manty, APRN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

722 Issued in MN

Practice address

4572 County Road 61
Moose Lake, MN 55767-9401

Phone

(218) 485-4481

Fax

(218) 485-5866

NPI assigned

Jul 26, 2007

Last updated

Mar 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cromwell Medical Clinic PLLCGroup PAC ID 5890861173, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Moose Lake Hospital, Moose Lake, MN, CCN 241350
• Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364
• Riverwood Healthcare Center Hospital, Aitkin, MN, CCN 241305

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: faith.manty@811393367080964.direct.elationemr.com
• Direct secure messaging: faith.peterson.1@13291.direct.athenahealth.com
• Direct secure messaging: faith.peterson@gfhc.eclinicaldirectplus.com
• Direct secure messaging: fmanty526007@direct.centracare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cromwell Medical Clinic PLLC

  • Primary Care Clinic/Center
  • Cromwell, MN
  • NPI 1821250549
  Medicare reassignment Care Compare group
• Dermatology Professionals, PA

  • Clinic/Center
  • Baxter, MN
  • NPI 1720269426
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aitkin Community Hospital, Inc.

  dba Riverwood Healthcare Center

  • Critical Access Hospital
  • Aitkin, MN
  • NPI 1942277835
  Care Compare affiliation
• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Care Compare affiliation
• Essentia Health Moose Lake

  • Critical Access Hospital
  • Moose Lake, MN
  • NPI 1154959880
  Care Compare affiliation
• Essentia Health Moose Lake

  dba Essentia Health Moose Lake Clinic

  • Critical Access Hospital Clinic/Center
  • Moose Lake, MN
  • NPI 1275102048
  Care Compare affiliation

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1124218102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 COUNTY ROAD 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679401",
            "telephone_number": "218-485-4481",
            "fax_number": "218-485-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 COUNTY ROAD 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679401",
            "telephone_number": "218-485-4481",
            "fax_number": "218-485-5866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Bunker Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Aitkin",
            "state": "MN",
            "postal_code": "564311865",
            "country_code": "US",
            "telephone_number": "218-927-2157",
            "fax_number": "218-927-5319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTY",
        "first_name": "FAITH",
        "middle_name": "A.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 137363-9",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894967000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.