LUKE A. MANTLE (NPI# 1992113054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992113054 |
| Entity Type | Individual |
| Full Name | LUKE A. MANTLE |
| Credential | M.D. |
| Practice Address |
3350 Main Street Springfield MA 01107 |
| Mailing Address |
280 Chestnut St 2nd Fl Springfield MA 01199-1001 |
| Practice Telephone | 4137940373 |
| Mailing Telephone | 4137945700 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2018-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 260624 | MA | Student, Health Care |
| Street Address |
3350 MAIN STREET |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215923800 | Donald J. Higby | Internal Medicine | 3350 Main Street, Springfield, MA 01199 | 2005-09-20 |
| 1336465715 | Dawn J Brooks | Internal Medicine | 3350 Main Street, Springfield, MA 01107 | 2010-04-11 |
| 1780695320 | Susan Cash | Surgery | 3350 Main Street, Springfield, MA 01199 | 2006-08-10 |
| 1003834920 | Grace Makari-judson | Internal Medicine | 3350 Main Street, Springfield, MA 01107-1112 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740702547 | Domingo Nieves Jr. | Counselor | 2225 Main St., Springfield, MA 01107 | 2017-07-13 |
| 1801318266 | Denise Lawson | Counselor | 2257 Main Street, Springfield, MA 01107 | 2017-07-07 |
| 1568912491 | Trina Cysz | Nurse Practitioner | 101 Wason Avenue, Commonwealth Care Alliance, Springfield, MA 01107 | 2016-10-04 |
| 1609322262 | Toheeb Oladimeji Bakare | Counselor | 322 Birnie Avenue, Springfield, MA 01107 | 2016-09-01 |
| 1952701161 | Jalissa Sostre | Counselor | 32 Abbe Ave, Springfield, MA 01107 | 2014-08-26 |
| 1659799161 | Elizabeth A. Otmaskin | Obstetrics & Gynecology | 3455 Main Street Suite C, Baysttate Ob Gyn Group Inc, Springfield, MA 01107 | 2014-04-01 |
| 1205268885 | Catherine Matejcek Davies | Counselor | 246 Park Street, Springfield, MA 01107 | 2013-08-06 |
| 1750723268 | Jasdeep S. Badwal | Allergy & Immunology | 2 Medical Center Dr Ste 406, Springfield, MA 01107 | 2013-07-25 |
| 1255691846 | Medical Express Urgent Care Center, Co. Inc. | Physical Medicine & Rehabilitation | 438 Chestnut Street, Springfield, MA 01107 | 2012-05-17 |
| 1205166642 | Matthew R Kelley | Audiologist | 100 Wason, Suite 100, Springfield, MA 01107 | 2010-01-07 |
| Find all providers in zip 01107 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773361 | Aarika Danielle Gardner | Student in an Organized Health Care Education/Training Program | 560 W Bryant Apt D207, Springfield, MO 65810-8329 | 2020-08-31 |
| 1134743073 | Jared Saylor | Student in an Organized Health Care Education/Training Program | 901 S National Ave, Prof 160, Springfield, MO 65897 | 2020-06-06 |
| 1659995694 | Erin Bowler | Student in an Organized Health Care Education/Training Program | 51 Ingersoll Grv, Springfield, MA 01109-4010 | 2020-06-05 |
| 1063035483 | Mary Anne Iellamo | Student in an Organized Health Care Education/Training Program | 3400 Main St Fl 2, Springfield, MA 01199-1003 | 2020-05-20 |
| 1760005359 | Hannah Elizabeth Schumann | Student in an Organized Health Care Education/Training Program | 1621 E Lark St, Springfield, MO 65804-4351 | 2020-05-18 |
| 1962024109 | Brittany Nicole Campbell | Student in an Organized Health Care Education/Training Program | 2266 Boysenberry Ln Apt 4, Springfield, IL 62711-5414 | 2020-05-11 |
| 1518587286 | Emily Lyn Street | Student in an Organized Health Care Education/Training Program | 38 Country Pl, Springfield, IL 62703-5310 | 2020-04-22 |
| 1730709411 | Mary Kathleen Simon | Student in an Organized Health Care Education/Training Program | 1820 S Wiggins Ave, Springfield, IL 62704-3335 | 2020-04-22 |
| 1225658131 | Sarah Colby Mchugh | Student in an Organized Health Care Education/Training Program | 759 Chestnut St # S5427, Springfield, MA 01199-0001 | 2020-04-21 |
| 1346879889 | Ashly Seby | Student in an Organized Health Care Education/Training Program | 86 Redwood Rd Fl 3, Springfield, NJ 07081-2426 | 2020-04-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01107 |
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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.