Active NPI
Pmmdoc Inc
- Emergency Medical Services (Emergency Medicine) Physician
- Pensacola, FL
National Provider Identifier
1053566380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- ME38433
- Legal business name
- PMMDOC INC
- Practice address
- 6435 Dunlieth Place
Pensacola, FL 32504-7887 - Phone
- (850) 478-0240
- Fax
- (850) 478-0502
- NPI assigned
- Dec 1, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Peter Michael Manis, M.D.
- Title
- President
- Phone
- (850) 478-0240
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | ME38433 | FL | Primary |
Addresses
Primary practice location
6435 Dunlieth Place
Pensacola, FL 32504-7887
Mailing address
6435 Dunlieth Place
Pensacola, FL 32504-7887
Phone (850) 478-0240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042767500 | Medicaid | FL |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1272585600000",
"number": "1053566380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6435 DUNLIETH PLACE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325047887",
"telephone_number": "850-478-0240",
"fax_number": "850-478-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6435 DUNLIETH PLACE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325047887",
"telephone_number": "850-478-0240",
"fax_number": "850-478-0502"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PMMDOC INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-01",
"last_updated": "2010-04-30",
"status": "A",
"authorized_official_last_name": "MANIS",
"authorized_official_first_name": "PETER",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "850-478-0240",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "FL",
"license": "ME38433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042767500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.