Individual provider Active NPI

Mary Noble, PA-C

  • Physician Assistant
  • Manistique, MI
National Provider Identifier
1992738710
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003951 Issued in MI
Practice address
500 Main St
Manistique, MI 49854-1522
Phone
(906) 341-2153
Fax
(906) 341-3299
NPI assigned
Jul 7, 2006
Last updated
Dec 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003951 MI Primary

Addresses

Primary practice location

500 Main St
Manistique, MI 49854-1522

Mailing address

7870W US Highway 2
Manistique, MI 49854-8992
Phone (906) 341-2153

Other identifiers 1

IdentifierTypeStateIssuer
0G71004OtherMIRHC BC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140219000732 MI Practitioner - Physician Assistant 6305075276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schoolcraft Memorial HospitalGroup PAC ID 4082525118, 30 clinicians

Practice addresses (Care Compare)

7870W US Hwy 2
Manistique, MI 49854-8992
Phone (906) 341-2153

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Schoolcraft Memorial Hospital CurrentSince Dec 15, 2013 Accepting new patients
Schoolcraft Memorial Hospital Past Accepting new patients

Locations

7870W US Highway 2
Manistique, MI 49854
Phone (906) 341-2153

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/71812193-7aa5-42d8-ba4c-ee45e2ea853f/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1992738710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-2153",
            "fax_number": "906-341-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MAIN ST",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541522",
            "telephone_number": "906-341-2153",
            "fax_number": "906-341-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC BC NUMBER",
            "identifier": "0G71004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistique, MI

Sources for this page

Verify at the official NPI Registry.