Justin Michael Mandosking

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

248 Ferry LN
Saint Ignace, MI 49781-1828

Phone

(108) 392-2167

NPI assigned

Dec 14, 2021

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1902565369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 BROWN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832212",
            "telephone_number": "906-259-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 FERRY LN",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811828",
            "telephone_number": "108-392-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDOSKING",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-14",
        "last_updated": "2023-06-20",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackinac Straits Hospital Authority (Mackinac Straits Hospital and Health Center)
• Mackinac Straits Hospital Authority (Mackinac Straits Hospital and Health Center)
• Mackinac Straits Hospital Authority (Mackinac Straits Hospital and Health Center)
• Mackinac Straits Hospital Authority (Mackinac Straits Hospital and Health Center)
• Jeff Madigan, L.P.C.
• Dorene Lois Mathews, LMSW
• James John Mattson, PT
• Stefanie Mattson
• Karli May Maurer
• Mark W Mercer, DDS

• Peer Specialist in Saint Ignace, MI
• Providers in Saint Ignace, MI by specialty
• Peer Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.