DR. MARTIN MARK KEIBEL (NPI# 1427067339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427067339 |
| Entity Type | Individual |
| Full Name | DR. MARTIN MARK KEIBEL |
| Practice Address |
574 Middle Tpke E Manchester CT 06040-3730 |
| Practice Telephone | 8606464334 |
| Practice Fax Number | 8606467020 |
| Mailing Telephone | 8606464334 |
| Mailing Fax Number | 8606467020 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-10-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 023567 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | MEDICARE RR | P00064445 | 01 |
| Street Address |
574 MIDDLE TPKE E |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-3730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073522991 | Barbara Louise Phillips | Family Medicine | 574 Middle Tpke E, Manchester, CT 06040-3730 | 2006-08-07 |
| 1669030177 | Alexis Deitz | Physician Assistant | 574 Middle Tpke E, Manchester, CT 06040-3730 | 2019-05-30 |
| 1992232813 | Simone V Gorski | Family Medicine | 574 Middle Tpke E, Manchester, CT 06040-3730 | 2017-05-23 |
| 1730566381 | Family Medicine Center | Physician Assistant | 574 Middle Tpke E, Manchester, CT 06040-3730 | 2015-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501333 | Mackenzie Lawler | Social Worker | 200 W. Center Street, Suite C-2-6, Manchester, CT 06040 | 2020-05-29 |
| 1386288009 | Monica Diaz | Social Worker | 117 East Center Street, Suite A1, Manchester, CT 06040 | 2019-11-06 |
| 1346881596 | Sheryl Andrine Henry | Technician | 185 Pine Street, Apt 014, Manchester, CT 06040 | 2019-09-30 |
| 1811550304 | Edward Wahn Lee | Student in an Organized Health Care Education/Training Program | 130 Hartford Road, Manchester, CT 06040 | 2019-04-19 |
| 1538689534 | Bernard Ashirifie | Counselor | 869 Main Street, Apt 3, Manchester, CT 06040 | 2017-06-21 |
| 1497275697 | Justin David Chung | Dentist | 483 Middle Tpke W Ste 209, Manchester, CT 06040 | 2017-06-20 |
| 1114473436 | Amanda Edgar | Counselor | 469 Center Street, Manchester, CT 06040 | 2016-08-28 |
| 1760831366 | Samantha Micael | Marriage & Family Therapist | 200 West Center Street, Suite C-2-6, Manchester, CT 06040 | 2016-06-06 |
| 1962856179 | Odelia Brew | Nurse Practitioner | 256 Hackmatack Street, Manchester, CT 06040 | 2016-04-14 |
| 1306217765 | Stephen R Machattie | Social Worker | 843 Main St Ste 11, Manchester, CT 06040 | 2015-10-12 |
| Find all providers in zip 06040 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002701 | Kathleen P Fantozzi | Family Medicine | 1590 Union St, Manchester, NH 03104-1768 | 2020-08-05 |
| 1669098570 | Manchester Family Healthcare | Family Medicine | 804 Keylon St Ste B, Manchester, TN 37355-2414 | 2020-06-17 |
| 1043790413 | Sabrina Bolianites | Family Medicine | 765 S Main St Ste 103, Manchester, NH 03102 | 2018-08-15 |
| 1063912459 | Manchester Alcoholism Rehabilitation Center | Family Medicine | 700 Lake Ave Ste 2, Manchester, NH 03103-2734 | 2018-02-13 |
| 1790204311 | Ballwin Family Medicine LLC | Family Medicine | 653 Big Bend Rd, Manchester, MO 63021-7723 | 2017-09-14 |
| 1659801892 | Pinnacle Health Regional Physicians | Family Medicine | 4314 N George St Ext'd, Manchester, PA 17345-1307 | 2017-06-19 |
| 1083092282 | Alexander Michael Jones | Family Medicine | 4 Elliot Way Ste 105, Manchester, NH 03103 | 2015-05-08 |
| 1164835138 | Amanda Sue Olberding | Family Medicine | 709 West Main St, Manchester, IA 52057 | 2014-06-08 |
| 1497171318 | Peter J Volk | Family Medicine | 23 Bowdoin Street, Manchester, ME 04351 | 2014-03-17 |
| 1689019242 | R. L. Williams Family Medicine, Pllc | Family Medicine | 1000 Mcarthur St, Manchester, TN 37355-2420 | 2013-05-08 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 06040 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.