Jeffrey L Mann, DO
Individual provider Active NPI Pediatrics Physician · Williamsburg, KY
NPI 1568435212 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1568435212
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- C2299 (KY)
- Practice address
- 65 N Highway 25 W
Williamsburg, KY 40769-1540 - Phone
- (606) 549-0123
- NPI assigned
- Feb 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2299 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sterling Area Health Center | Current |
Accepting new patients | |
| Sterling Area Health Center | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C2299 | KY | Yes |
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
Other providers in Williamsburg, KY
- Melissa Ann Lawson
- Morgan Lay
- Lindsay J Ledwich
- William Linscomb
- Rick Loudermelt
- Brittany Manus
- Stephanie Denise Martin
- Elisa Bennett Mauldin
- Allison Lynn Maxey
- Erin Kristen Maxey
All providers in Williamsburg, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.