Individual provider Active NPI

Jeffrey L Mann, DO

  • Pediatrics Physician
  • Williamsburg, KY
National Provider Identifier
1568435212
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C2299 Issued in KY
Practice address
65 N Highway 25 W
Williamsburg, KY 40769-1540
Phone
(606) 549-0123
NPI assigned
Feb 10, 2006
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C2299 KY Primary

Addresses

Primary practice location

65 N Highway 25 W
Williamsburg, KY 40769-1540

Mailing address

65 N Highway 25 W
Williamsburg, KY 40769-1540
Phone (606) 549-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201218000724 MI Practitioner - Pediatric Medicine 9931362993 Reassigns benefits to 1 organization
I20240408001106 KY Practitioner - Pediatric Medicine 9931362993 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Area Health Center CurrentSince Sep 15, 2020 Accepting new patients
Sterling Area Health Center CurrentSince Sep 15, 2020 Accepting new patients
Health Solutions LLC Past Accepting new patients

Locations

436 W Main St
Hale, MI 48739
Phone (989) 728-2800

725 E State St
Sterling, MI 48659
Phone (517) 654-2491

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1568435212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N HIGHWAY 25 W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691540",
            "telephone_number": "606-549-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N HIGHWAY 25 W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691540",
            "telephone_number": "606-549-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "C2299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

Sources for this page

Verify at the official NPI Registry.