Mikaela Mantele, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004126 Issued in GA

Practice address

101 Fairview Park Dr
Dublin, GA 31021-2501

Phone

(478) 272-7494

NPI assigned

Oct 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bass Physical Therapy and Rehabilitation Center Inc

  • Rehabilitation Clinic/Center
  • Swainsboro, GA
  • NPI 1942347687
  NPD (past)
• Bass Physical Therapy and Rehabilitation Center, Inc.

  • Rehabilitation Clinic/Center
  • Dublin, GA
  • NPI 1952383093
  NPD (past)

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1326515610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 RAINBOW RD",
            "city": "ELLABELL",
            "state": "GA",
            "postal_code": "313088587",
            "telephone_number": "303-717-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FAIRVIEW PARK DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212501",
            "telephone_number": "478-272-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELE",
        "first_name": "MIKAELA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mann Medical Complex
• Phyllis Mary Mann, LPN
• Qwuayana Manner, CPHT
• Heather Joiner Manning, COTA/L
• Henry A Manning, PA C
• Anthony Margiotta Jr., LMSW
• Mark a Everson Medical Supply
• Mark L. Boles, MD
• Danielle Paige Martin, NP-C
• Donna Martin, SOCIAL WORKER

• Physical Therapy Assistant in Dublin, GA
• Providers in Dublin, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.