Individual provider Active NPI

James E Manint, D.O.

  • Family Medicine Physician
  • Monticello, IL
National Provider Identifier
1376534420
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-058029 Issued in IL
Practice address
1111 N State St
Monticello, IL 61856-1104
Phone
(217) 762-2506
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-058029 IL Primary

Addresses

Primary practice location

1111 N State St
Monticello, IL 61856-1104

Mailing address

1000 Medical Center Dr
Monticello, IL 61856-2116
Phone (217) 762-6241

Other practice location 1

1000 Medical Center Dr
Monticello, IL 61856-2116
Phone (217) 762-6241

Other identifiers 2

IdentifierTypeStateIssuer
36058029MedicaidIL
036-058029OtherILSTATE LICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmanint@kmc.kirbymedicalcenter.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000244 IL Practitioner - Family PracticePractitioner - Geriatric MedicinePractitioner - Other (Physician) 7911892161 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-058029ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Piatt County Nursing HomeMonticello, IL, CCN 145883 Skilled nursing facility W-2 Managing Employee
Operational/Managerial Control
Adp of the SNF
Jun 1, 2022
Dec 12, 2024
Dec 27, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1376534420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618562116",
            "telephone_number": "217-762-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N STATE ST",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618561104",
            "telephone_number": "217-762-2506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "IL",
            "postal_code": "618562116",
            "country_code": "US",
            "telephone_number": "217-762-6241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANINT",
        "first_name": "JAMES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-058029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36058029",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "036-058029",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmanint@kmc.kirbymedicalcenter.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Medical Center Dr",
            "city": "Monticello",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618562116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monticello, IL

Sources for this page

Verify at the official NPI Registry.