MANDEVILLE ANNE WAKEFIELD SOFER DO
NPI 1699578963
Student in an Organized Health Care Education/Training Program in Marietta, GA

Q: What is Mandeville Sofer's NPI number?

The NPI number for Mandeville Sofer is 1699578963. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Q: What is Mandeville Sofer's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Mandeville Sofer was last updated on March 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 31, 2025PECOS Enrolled

677 CHURCH ST NE, MARIETTA, GA 30060(770) 793-6194 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mandeville Anne Wakefield Sofer Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANDEVILLE ANNE WAKEFIELD SOFER DO (NPI 1699578963) is an individual student in an organized health care education/training program in Marietta, Georgia and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699578963

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameMANDEVILLE ANNE WAKEFIELD SOFERCredential: DO

Location Address677 CHURCH ST NEMarietta, GA 30060-1101

Mailing Address3221 Thomas AveMontgomery, AL 36106-2427

Phone(770) 793-6194

Sole ProprietorYes

Enumeration DateMarch 31, 2025

NPPES CertifiedMarch 30, 2025

✔ NPI 1699578963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

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.

677 CHURCH ST NE, Marietta, GA 30060

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mandeville Anne Wakefield Sofer Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.