Individual provider Active NPI

Jonathan Kenneth Marner, M.D.

  • Anesthesiology Physician
  • Saint Joseph, MI
National Provider Identifier
1154852184
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301506457 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 983-8536
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036152112 IL
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 4301506457 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9169

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, IL, TN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20210716001052 IN Practitioner - Anesthesiology 2264705144
I20220721000684 MI Practitioner - Anesthesiology 2264705144 Reassigns benefits to 1 organization
I20230328001415 IL Practitioner - Anesthesiology 2264705144 Reassigns benefits to 1 organization
I20241018003047 TN Practitioner - Anesthesiology 2264705144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Louisville School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia II, PLLCGroup PAC ID 2668658493, 39 clinicians
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians

Practice addresses (Care Compare)

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036152112ILMDAnesthesiology Physician
4301506457MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Anesthesiology CurrentSince Jan 30, 2023 Accepting new patients
Lifelinc Anesthesia VIII PLLC Anesthesiology CurrentSince Oct 1, 2024 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jun 20, 2022 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Current Accepting new patients
Lifelinc Anesthesia II, PLLC Anesthesiology CurrentSince Aug 1, 2024 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Anesthesiology CurrentSince Jun 20, 2022 Accepting new patients
Surgical Anesthesia Associates, PLLC Anesthesiology Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

Organizations & group practices 7

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1154852184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9169",
            "fax_number": "708-216-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-983-8536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9169",
            "fax_number": "708-216-1249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARNER",
        "first_name": "JONATHAN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036152112",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301506457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.