Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Manilla

Individual provider Nurse Practitioner · NPI 1649726829

Mary Manilla is a Nurse Practitioner in Byron Center, Michigan. Qualified in 2016, 10 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
10
Licensed in
MI
In the registry since
2016
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Practice location Address checks out

7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001
Phone: (616) 267-7668
Fax: (616) 267-7941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704285854 (MI)

Record details

NPI number1649726829
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 29, 2016
Last updated in NPPESFebruary 25, 2021
Certification dateFebruary 25, 2021
Mailing address100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Byron Center