Individual provider Active NPI

Peter Douglas Mantell III

  • Peer Specialist
  • Turners Falls, MA
National Provider Identifier
1235762741
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
130 Millers Falls Rd
Turners Falls, MA 01376-2250
Phone
(413) 835-1564
NPI assigned
Feb 13, 2020
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

130 Millers Falls Rd
Turners Falls, MA 01376-2250

Mailing address

130 Millers Falls Rd
Turners Falls, MA 01376-2250
Phone (413) 835-1564

Other identifiers 1

IdentifierTypeStateIssuer
175T00000XOtherMACLINICAL AND SUPPORT OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1235762741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MILLERS FALLS RD",
            "city": "TURNERS FALLS",
            "state": "MA",
            "postal_code": "013762250",
            "telephone_number": "413-835-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MILLERS FALLS RD",
            "city": "TURNERS FALLS",
            "state": "MA",
            "postal_code": "013762250",
            "telephone_number": "413-835-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELL",
        "first_name": "PETER",
        "middle_name": "DOUGLAS",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL AND SUPPORT OPTIONS",
            "identifier": "175T00000X",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turners Falls, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.