Active NPI
Jeffrey A. Manwaring, M.S., CCC-A
- Audiologist
- St George, UT
National Provider Identifier
1013994631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 263454-4101
- Practice address
- 1490 East Foremaster Drive
Suite 140
St George, UT 84790-4488 - Phone
- (435) 688-2456
- Fax
- (435) 986-4096
- NPI assigned
- Dec 23, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 263454-4101 | UT | Primary |
Addresses
Primary practice location
1490 East Foremaster Drive
Suite 140
St George, UT 84790-4488
Mailing address
1490 E Foremaster Dr
Suite 140
St George, UT 84790-4488
Phone (435) 688-2456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000057179 | Medicaid | UT |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 263454-4101 | UT | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1013994631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1490 E FOREMASTER DR",
"address_2": "SUITE 140",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847904488",
"telephone_number": "435-688-2456",
"fax_number": "435-986-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1490 EAST FOREMASTER DRIVE",
"address_2": "SUITE 140",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847904488",
"telephone_number": "435-688-2456",
"fax_number": "435-986-4096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANWARING",
"first_name": "JEFFREY",
"middle_name": "A.",
"credential": "M.S., CCC-A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "UT",
"license": "263454-4101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000057179",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.