DR. GARY MARC MANTELL (NPI# 1750305892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750305892 |
| Entity Type | Individual |
| Full Name | DR. GARY MARC MANTELL |
| Credential | D.P.M. |
| Practice Address |
5180 Park Ave Ste 220 Memphis TN 38119-3530 |
| Practice Telephone | 9016824668 |
| Practice Fax Number | 9016832963 |
| Mailing Telephone | 9016824668 |
| Mailing Fax Number | 9016832963 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
DPM283 | TN | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
DPM283 | TN | Podiatric Medicine & Surgery Service Providers |
| Street Address |
5180 PARK AVE STE 220 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-3530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417469628 | Jojuan Fullwiley | Behavioral Analyst | 6685 Quince Rd Ste 116, Memphis, TN 38119 | 2017-10-27 |
| 1336675297 | Jill Budynas Depriest | Counselor | 5583 Murray Ave Ste 203, Memphis, TN 38119 | 2017-05-11 |
| 1396279220 | Glen Matthew Stamps Jr. | Counselor | 5583 Murray Ave Ste 207, Memphis, TN 38119 | 2017-04-18 |
| 1598117442 | Hazel Aberdeen | Chiropractor | 1911 Memphis Tennessee, Memphis, TN 38119 | 2016-07-04 |
| 1831569060 | E-c-t Non Emergency Medical Transport | Non-emergency Medical Transport (VAN) | 6869 Woodlake Dr, Memphis, TN 38119 | 2015-09-30 |
| 1053781617 | Astrid Roman | Dietitian, Registered | 8020 Hillside Cv, Memphis, MS 38119 | 2015-09-25 |
| 1467857664 | Allan Jacob Katz | Counselor | 5668 Rex Rd, Suite 104, Memphis, TN 38119 | 2014-10-30 |
| 1962836015 | Judy Ann Harrick | Acupuncturist | 5575 Poplar Ave., #702, Memphis, TN 38119 | 2013-08-26 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1578833620 | Elizabeth Mary Dion-douglass | Pharmacist | 2891 Kirby Parkway, Memphis, TN 38119 | 2012-01-06 |
| Find all providers in zip 38119 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093838187 | Paul William Hutchison, Dpm | Podiatrist | 7878 Winchester Road, Memphis, TN 38125 | 2007-04-06 |
| 1558818666 | We Heel The Sole Podiatry LLC | Podiatrist | 1750 Madison Ave, Suite 260, Memphis, TN 38104-6492 | 2016-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366619199 | Paul W. Hutchison | Podiatrist | 1723 Highway 51 S Ste C, Covington, TN 38019-3628 | 2008-05-12 |
| 1891914545 | Michael Warren Lawrence | Podiatrist | 1018 Dallas Rd Ste 304, Chattanooga, TN 37405-2707 | 2007-04-24 |
| 1548304405 | Richard S. Eby | Podiatrist | 3603 E Ringgold Rd, Chattanooga, TN 37412-1247 | 2007-02-16 |
| 1841308244 | Joseph Bernard Neubauer | Podiatrist | 1719 Wiltshire Dr, Murfreesboro, TN 37129-1085 | 2006-08-26 |
| 1568473320 | Robert J Schreiber | Podiatrist | 1705 Wedgewood Dr, Columbia, TN 38401-3529 | 2006-08-10 |
| 1730101734 | Maryville Foot Clinic Inc | Podiatrist | 1515 E Lamar Alexander Pkwy, Maryville, TN 37804-5131 | 2006-07-25 |
| 1760410260 | Robert Tucker Spalding Jr. | Podiatrist | 1225 Taft Hwy, Signal Mountain, TN 37377-3251 | 2006-06-30 |
| 1588616098 | Mark B Hellmann | Podiatrist | 1855 Tanner Way Ste 130, Harriman, TN 37748-8331 | 2006-05-16 |
| 1043207988 | Vincent B Longobardo | Podiatrist | 19 Miracle Ln, Suite 200, Crossville, TN 38555-7654 | 2005-10-05 |
| 1417952581 | Tod Raymond Bushman | Podiatrist | 3024 Business Park Cir, Goodlettsville, TN 37072-3132 | 2005-06-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. GARY MARC MANTELL.
| 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.