Organization Active NPI

Pmmdoc Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Pensacola, FL
National Provider Identifier
1053566380
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
ME38433 Issued in FL
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

Updated by the provider on Apr 30, 2010

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)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
042767500MedicaidFL

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.