Kenneth W. Manuele, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19106 Issued in OR

Practice address

500 5TH St
Brookings, OR 97415-9702

Phone

(541) 412-2000

Fax

(541) 412-2081

NPI assigned

Jun 8, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Chetco Medical & Aesthetics LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Brookings, OR
  • NPI 1316555428
  NPD (past)
• Urgent Care NW Gresham PC

  • Urgent Care Clinic/Center
  • Gresham, OR
  • NPI 1336128321
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1962442657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "541-412-2000",
            "fax_number": "541-412-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "541-412-2000",
            "fax_number": "541-412-2081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97825 Shopping Center Ave",
            "address_purpose": "LOCATION",
            "city": "Brookings",
            "state": "OR",
            "postal_code": "97415",
            "country_code": "US",
            "telephone_number": "541-469-2330",
            "fax_number": "541-469-8984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANUELE",
        "first_name": "KENNETH",
        "middle_name": "W.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "19106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY GENERAL HOSPITAL'S NPI",
            "identifier": "1487696985",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151326",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY MEDICAL CENTER'S NPI",
            "identifier": "1083656367",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Living Well Medical, LLC
• Gwen Lovetere, L.AC., M.AC.O.M.
• Luz Family Medical Practice LLC
• Cheryl L Malo-Clines, NP
• Kori Mansel
• Marian L Boye
• Teresa Martin
• Madeline Judith Martincic
• Alaya Rose Martinez-Rodriguez
• Gary James Mauro, QMHP-C

• Family Medicine Physician in Brookings, OR
• Providers in Brookings, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.