Organization Active NPI

Manistee Orthopaedics

  • Orthopaedic Surgery Physician
  • Manistee, MI
National Provider Identifier
1467539569
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301046367 Issued in MI
Legal business name
MANISTEE ORTHOPAEDICS
Practice address
1293 E Parkdale Ave
Suite 2200
Manistee, MI 49660-8904
Phone
(231) 398-1750
Fax
(231) 398-1751
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Tammy Bauman
Title
Biller
Phone
(231) 398-1752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 4301046367 MI Primary

Addresses

Primary practice location

1293 E Parkdale Ave
Suite 2200
Manistee, MI 49660-8904

Mailing address

1293 E Parkdale Ave
Suite 2200
Manistee, MI 49660-8904
Phone (231) 398-1750

Other identifiers 2

IdentifierTypeStateIssuer
2005155171OtherMIBCBS
4743229MedicaidMI

National Provider Directory

National Provider Directory

Locations

1293 E Parkdale Ave
Ste 2200
Manistee, MI 49660
Phone (231) 398-1750

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467539569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 E PARKDALE AVE",
            "address_2": "SUITE 2200",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496608904",
            "telephone_number": "231-398-1750",
            "fax_number": "231-398-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 E PARKDALE AVE",
            "address_2": "SUITE 2200",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496608904",
            "telephone_number": "231-398-1750",
            "fax_number": "231-398-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANISTEE ORTHOPAEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAUMAN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "231-398-1752",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301046367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2005155171",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4743229",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.