Haron Nyakundi Manwa

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6804 Issued in MN

Practice address

3301 7TH Ave
Anoka, MN 55303-4516

Phone

(651) 431-5000

NPI assigned

Aug 7, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Harman Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Champlin, MN
  • NPI 1033866744
  NPD Authorized official
• Anoka Metro Regional Treatment Center

  • Psychiatric Hospital
  • Anoka, MN
  • NPI 1275585564
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1003461864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7223 114TH LN N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162860",
            "telephone_number": "612-532-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 7TH AVE",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034516",
            "telephone_number": "651-431-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANWA",
        "first_name": "HARON",
        "middle_name": "NYAKUNDI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia M Mandac, M.D.
• Mande Family Care LLC
• Samantha Manning
• Stephanie Mantini
• Manuel Chiropractic Center
• Audrey Marshall
• Lindsey Mason, MA, LPCC
• Kristin R Masterton, LICSW
• Trisha Matter
• Nora Matthews, LPCC

• Psychiatric/Mental Health Nurse Practitioner in Anoka, MN
• Providers in Anoka, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.