Individual provider Active NPI

Melanie S Manary, M.D.

  • Internal Medicine Physician
  • Petoskey, MI
National Provider Identifier
1437156940
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301407159 Issued in MI
Practice address
560 W Mitchell St
Ste 300
Petoskey, MI 49770-2278
Phone
(231) 487-2460
Fax
(231) 487-6596
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301407159 MI Primary

Addresses

Primary practice location

560 W Mitchell St
Ste 300
Petoskey, MI 49770-2278

Mailing address

560 W Mitchell St
Ste 300
Petoskey, MI 49770-2278
Phone (231) 487-2460

Other identifiers 1

IdentifierTypeStateIssuer
104116701MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301407159MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan Current Accepting new patients

Locations

748 S Main St
Cheboygan, MI 49721
Phone (231) 627-5601

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

560 W Mitchell St
Ste 300
Petoskey, MI 49770
Phone (231) 487-2460

Organizations & group practices 3

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1437156940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "STE 300",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702278",
            "telephone_number": "231-487-2460",
            "fax_number": "231-487-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "STE 300",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702278",
            "telephone_number": "231-487-2460",
            "fax_number": "231-487-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANARY",
        "first_name": "MELANIE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301407159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104116701",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.