Active NPI
Manton Health Center,P LLC
- Family Medicine Physician
- Manton, MI
National Provider Identifier
1669766705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MANTON HEALTH CENTER,P LLC
- Practice address
- 115 E 7TH St
Manton, MI 49663-9429 - Phone
- (231) 715-6131
- NPI assigned
- Jun 7, 2011
- 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
- Renee Marie Killian
- Title
- Admin
- Phone
- (231) 715-6131
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
115 E 7TH St
Manton, MI 49663-9429
Mailing address
829 Traditions Dr
Traverse City, MI 49696-8965
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Williamsburg, MI
- NPI 1538184551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1344211200000",
"number": "1669766705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "829 TRADITIONS DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496968965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E 7TH ST",
"city": "MANTON",
"state": "MI",
"postal_code": "496639429",
"telephone_number": "231-715-6131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MANTON HEALTH CENTER,P LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-06-07",
"last_updated": "2012-08-06",
"status": "A",
"authorized_official_last_name": "KILLIAN",
"authorized_official_first_name": "RENEE",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "ADMIN",
"authorized_official_telephone_number": "231-715-6131"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.