Active NPI
Manistee Orthopaedics
- Orthopaedic Surgery Physician
- Manistee, MI
National Provider Identifier
1467539569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 4301046367
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2005155171 | Other | MI | BCBS |
| 4743229 | Medicaid | MI |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Orthopaedic Surgery Physician
- Manistee, MI
- NPI 1972509487
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.