Manubay Medical Clinic MD Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MOMDR6794 Issued in MO

Legal business name

MANUBAY MEDICAL CLINIC MD INC

Practice address

1312 1St St
Kennett, MO 63857-2526

Phone

(573) 888-1224

Fax

(573) 888-9823

NPI assigned

Nov 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Teresita I Manubay, M.D.

Title

Owner

Phone

(573) 888-9823

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• TERESITA I. MANUBAY M.D. Doing business as

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1861792103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572526",
            "telephone_number": "573-888-1224",
            "fax_number": "573-888-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572526",
            "telephone_number": "573-888-1224",
            "fax_number": "573-888-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUBAY MEDICAL CLINIC MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "MANUBAY",
        "authorized_official_first_name": "TERESITA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-888-9823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "MOMDR6794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107995001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200363505",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TERESITA I. MANUBAY M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jerid Maddox, PHARM.D.
• Melissa Renee Malady
• William Paul Malloy
• Ashley Nicole Malone-Durham, RBT
• Trinity Ciara Malone
• Teodoro A Manubay, M.D.
• Teresita I Manubay, MD
• Sophia Elizabeth Marino
• Keila Yasmine Marroquin
• Lisa Nicole Marshall

• Pediatrics Physician in Kennett, MO
• Providers in Kennett, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.