Individual provider Active NPI

Heather F Mannor, P.A.-C

  • Physician Assistant
  • Fenton, MI
National Provider Identifier
1497722870
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002365 Issued in MI
Practice address
102 N Adelaide St
Fenton, MI 48430-2670
Phone
(810) 629-2245
Fax
(810) 629-6535
NPI assigned
Mar 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002365 MI Primary

Addresses

Primary practice location

102 N Adelaide St
Fenton, MI 48430-2670

Mailing address

2749 Birchwood Dr
Howell, MI 48855-7645
Phone (517) 545-2512

Other identifiers 1

IdentifierTypeStateIssuer
MM0921723OtherMIMEDICARE RR ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622000130 MI Practitioner - Physician Assistant 0143205484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fenton Medical CenterGroup PAC ID 4183605819, 9 clinicians

Practice addresses (Care Compare)

102 N Adelaide
Fenton, MI 48430-2670

102 N Adelaide St
Fenton, MI 48430-2670
Phone (810) 629-9461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002365MIMDPhysician Assistant

Organizations & group practices 1

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497722870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 BIRCHWOOD DR",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488557645",
            "telephone_number": "517-545-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N ADELAIDE ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302670",
            "telephone_number": "810-629-2245",
            "fax_number": "810-629-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNOR",
        "first_name": "HEATHER",
        "middle_name": "F",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR ID",
            "identifier": "MM0921723",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.