K. Grant Mansell, D.O., P.a.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

OS9748 Issued in FL

Legal business name

K. GRANT MANSELL, D.O., P.A.

Practice address

3535 Military TRL
Suite 205
Jupiter, FL 33458-5009

Phone

(561) 529-2625

Fax

(561) 529-2651

NPI assigned

Oct 10, 2016

Last updated

Oct 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Grant Mansell, D.O.

Title

President

Phone

(561) 529-2625

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1366992844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MILITARY TRL",
            "address_2": "SUITE 205",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585009",
            "telephone_number": "561-529-2625",
            "fax_number": "561-529-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MILITARY TRL",
            "address_2": "SUITE 205",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585009",
            "telephone_number": "561-529-2625",
            "fax_number": "561-529-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. GRANT MANSELL, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "MANSELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-529-2625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "OS9748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.