Active NPI
Sheila R Mane, MD
- Internal Medicine Physician
- Kingman, AZ
National Provider Identifier
1720009814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 27651
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 474742 | Medicaid | AZ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051201000778 | AZ | Practitioner - Internal Medicine | 7810917143 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27651 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheila R Mane MD PC | Internal Medicine | Current | Accepting new patients |
| Mohave Nephrology,PC | Past | 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.
-
- Nephrology Physician
- Kingman, AZ
- NPI 1669798823
-
- Community/Retail Pharmacy
- Memphis, TN
- NPI 1225723133
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Memphis, TN
- NPI 1245383355
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.