Individual provider Active NPI

Sheila R Mane, MD

  • Internal Medicine Physician
  • Kingman, AZ
National Provider Identifier
1720009814
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27651 Issued in AZ
Practice address
3535 E Andy Devine Ave
Kingman, AZ 86401-3412
Phone
(928) 681-3960
Fax
(928) 692-0067
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27651 AZ Primary

Addresses

Primary practice location

3535 E Andy Devine Ave
Kingman, AZ 86401-3412

Mailing address

3535 E Andy Devine Ave
Kingman, AZ 86401-3412
Phone (928) 681-3960

Other identifiers 1

IdentifierTypeStateIssuer
474742MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051201000778 AZ Practitioner - Internal Medicine 7810917143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27651AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheila R Mane MD PC Internal Medicine CurrentSince Nov 1, 1999 Accepting new patients
Mohave Nephrology,PC PastSince Nov 1, 1999 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

3535 E Andy Devine Ave
Kingman, AZ 86401
Phone (520) 757-3176

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1720009814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 E ANDY DEVINE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864013412",
            "telephone_number": "928-681-3960",
            "fax_number": "928-692-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 E ANDY DEVINE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864013412",
            "telephone_number": "928-681-3960",
            "fax_number": "928-692-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANE",
        "first_name": "SHEILA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "27651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474742",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.