Active NPI
Christopher P Manzone, PA C
- Medical Physician Assistant
- Atlanta, GA
National Provider Identifier
1053429548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA60044453
- Practice address
- Internal Medicine Health Care Team a
20 Glenlake Parkway
Atlanta, GA 30328 - Phone
- (404) 365-0966
- Fax
- (770) 677-7333
- NPI assigned
- Aug 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA60044453 | WA | Primary |
Addresses
Primary practice location
Internal Medicine Health Care Team a
20 Glenlake Parkway
Atlanta, GA 30328
Mailing address
1230 7TH Ave
Module E
Longview, WA 98632-3166
Phone (770) 595-1289
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA60044453 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients |
Locations
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Organizations & group practices 2
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
WA
-
- General Practice Physician
- Portland, OR
- NPI 1871848457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233532800000",
"number": "1053429548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 7TH AVE",
"address_2": "MODULE E",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986323166",
"telephone_number": "770-595-1289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "INTERNAL MEDICINE HEALTH CARE TEAM A",
"address_2": "20 GLENLAKE PARKWAY",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30328",
"telephone_number": "404-365-0966",
"fax_number": "770-677-7333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZONE",
"first_name": "CHRISTOPHER",
"middle_name": "P",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-26",
"last_updated": "2009-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA60044453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.