Individual provider Active NPI

Mary S Manz, R.N.

  • Registered Nurse
  • Dalton, WI
National Provider Identifier
1285603787
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
49793-030 Issued in WI
Practice address
N 793 Elm Street
Dalton, WI 53926-0002
Phone
(920) 394-3791
NPI assigned
Mar 16, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 49793-030 WI Primary

Addresses

Primary practice location

N 793 Elm Street
Dalton, WI 53926-0002

Mailing address

N793 Elm Street
PO Box 2
Dalton, WI 53926-0002
Phone (920) 394-3791

Other identifiers 1

IdentifierTypeStateIssuer
39939700MedicaidWI

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
49793-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285603787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N793 ELM STREET",
            "address_2": "PO BOX 2",
            "city": "DALTON",
            "state": "WI",
            "postal_code": "539260002",
            "telephone_number": "920-394-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N 793 ELM STREET",
            "city": "DALTON",
            "state": "WI",
            "postal_code": "539260002",
            "telephone_number": "920-394-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZ",
        "first_name": "MARY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "49793-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39939700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.