Active NPI
Cynthia Ann Manes, PT
- Physical Therapist
- Tyler, TX
National Provider Identifier
1003956814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1053130
- Practice address
- 305 S Broadway Ave
500
Tyler, TX 75702-7307 - Phone
- (903) 245-6632
- Fax
- (903) 531-2451
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1053130 | TX | Primary |
Addresses
Primary practice location
305 S Broadway Ave
500
Tyler, TX 75702-7307
Mailing address
1218 Dogwood St
Tyler, TX 75701-5236
Phone (903) 245-6632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10531 | TX | MD | Chiropractor |
| 1053130 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197244800000",
"number": "1003956814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 DOGWOOD ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757015236",
"telephone_number": "903-245-6632",
"fax_number": "903-531-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 S BROADWAY AVE",
"address_2": "500",
"city": "TYLER",
"state": "TX",
"postal_code": "757027307",
"telephone_number": "903-245-6632",
"fax_number": "903-531-2451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANES",
"first_name": "CYNTHIA",
"middle_name": "ANN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2007-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1053130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.