MARK W MATTINGLY (NPI# 1851442180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851442180 |
| Entity Type | Individual |
| Full Name | MARK W MATTINGLY |
| Credential | MD |
| Practice Address |
G4007 W Court St Suite E Flint MI 48532-3560 |
| Practice Telephone | 8107320908 |
| Practice Fax Number | 8107321630 |
| Mailing Telephone | 8107320908 |
| Mailing Fax Number | 8107321630 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208C00000X | Colon & Rectal Surgery | 4301068512 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MCARE | 11500 | 01 |
| MI | MEDICAID | 4590228 | 01 |
| MI | BLUE CROSS COMMUNITY BLUE | BLUE CROSS COMMUNITY | 01 |
| MI | MEDICARE | 0N53520 | 01 |
| MI | BLUE SHIELD BLUE SHIELD | BLUE CROSS BLUE SHIE | 01 |
| MI | AETNA | 7676408 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134249238 | Mark Mattingly | Physical Therapist | 434 N West St, Perryville, MO 63775-1359 | 2007-03-30 |
| 1962499293 | Mark Sean Mattingly | Nurse Anesthetist, Certified Registered | 230 N Broad St, Philadelphia, PA 19102-1121 | 2005-10-03 |
| 1073500757 | Mark E. Mattingly | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2005-09-29 |
| Street Address |
G4007 W COURT ST SUITE E |
| City | FLINT |
| State | MI |
| Zip Code | 48532-3560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295752772 | Rama Devi Rao | Pain Medicine | G4007 W Court St, Suite.f, Flint, MI 48532-3560 | 2006-07-17 |
| 1992340376 | Kristine Cargill | Nurse Practitioner | G4007 W Court St, Flint, MI 48532-3560 | 2019-11-09 |
| 1306372339 | Kappel Elite LLC | Nurse Practitioner | G4007 W Court St, Ste G2, Flint, MI 48532-3560 | 2017-05-11 |
| 1356682587 | Ashish Thomas | Physical Therapist | G4007 W Court St, Suite G2, Flint, MI 48532-3560 | 2013-03-13 |
| 1013278464 | Kelly Martin | Dentist | G4007 W Court St, #d, Flint, MI 48532-3560 | 2012-06-01 |
| 1619114550 | Bernadette Aldea | Physical Therapist | G4007 W Court St, Suite #g2, Flint, MI 48532-3560 | 2009-01-14 |
| 1962656009 | New Era Physical Therapy PC | Clinic/Center | G4007 W Court St, Suite #g2, Flint, MI 48532-3560 | 2008-11-14 |
| 1184820441 | Michael A Kia Do PC | Surgery | G4007 W Court St, Suite E, Flint, MI 48532-3560 | 2007-06-25 |
| 1659497220 | David Alan Boike | Dentist | G4007 W Court St, Suite D, Flint, MI 48532-3560 | 2007-03-22 |
| 1548386121 | Shayhana Ebrahim | Dentist | G4007 W Court St, Suite D, Flint, MI 48532-3560 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1639709496 | Tammara Kamei | Counselor | 2425 S.linden Rd, Suite D Unit 100, Flint, MI 48532 | 2020-01-21 |
| 1306481882 | Christine Rice | Case Manager/Care Coordinator | 3169 Beecher Road, Flint, MI 48532 | 2019-11-08 |
| 1780154336 | Sarah Marie Shaw | Case Manager/Care Coordinator | 2091 Professional Drive, Flint, MI 48532 | 2018-11-27 |
| 1215412093 | Adria D Haynes | Social Worker | G-4413 Corunna Rd., Flint, MI 48532 | 2018-09-27 |
| 1689159378 | Vip Smiles Dentistry, Pllc | Dentist | 1104 South Linden Rd, Building B, Suite 1, Flint, MI 48532 | 2018-09-27 |
| 1942794797 | Premier Eye Specialists Pllc | Ophthalmology | 1160 S Linden Rd, Bldg. 1 Ste. A, Flint, MI 48532 | 2018-06-15 |
| 1720587710 | Cassandra Socia | Dental Hygienist | G3222 Beecher Road, Flint, MI 48532 | 2018-02-06 |
| 1235660291 | Ashley L Boltjes | Massage Therapist | 3277 Beecher Rd, Flint, MI 48532 | 2017-03-22 |
| 1497202774 | Tyneshia Mcfarland | Home Health | 2104 Ridgecliffe Dr, Flint, MI 48532 | 2016-09-05 |
| Find all providers in zip 48532 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528450277 | Chelsea Elizabeth Smith | Colon & Rectal Surgery | 3500 Calkins Rd Ste A, Flint, MI 48532-3500 | 2015-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649566068 | Kristin M Busch | Colon & Rectal Surgery | 4201 Campus Ridge Dr, Midland, MI 48640-6128 | 2011-06-23 |
| 1215245329 | Warren P Mazier | Colon & Rectal Surgery | 7701 Conservation St Ne, Ada, MI 49301-9522 | 2010-09-23 |
| 1346566908 | William Lionel Beauregard | Colon & Rectal Surgery | 4406 Birch Run Dr, Troy, MI 48098-4341 | 2010-04-07 |
| 1114140167 | Ralph D Pearlman Md PC | Colon & Rectal Surgery | 22250 Providence Dr Ste 702, Southfield, MI 48075-6215 | 2007-04-10 |
| 1770637753 | Chairat Chomchai | Colon & Rectal Surgery | 28111 Hoover Road, Suite 6a, Warren, MI 48093 | 2007-01-23 |
| 1225191844 | John C. Eggenberger | Colon & Rectal Surgery | 5325 Elliott Dr Ste 104, Ypsilanti, MI 48197-8633 | 2006-12-18 |
| 1518051358 | Colon and Rectal Surgery Associates PC | Colon & Rectal Surgery | 1126 Gull Rd, Kalamazoo, MI 49048 | 2006-10-03 |
| 1568569655 | Farouk S Tootla | Colon & Rectal Surgery | 44060 Woodward Ave, Bloomfield Hills, MI 48302-5038 | 2006-09-20 |
| 1962470435 | Harold D Friedl | Colon & Rectal Surgery | 1126 Gull Road, Colon and Rectal Surgery Associates PC, Kalamazoo, MI 49048-1726 | 2006-03-10 |
| 1619950631 | Ganesh R Deshmukh | Colon & Rectal Surgery | 3106 S Wayne Rd, Wayne, MI 48184 | 2005-11-23 |
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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.