Individual provider Active NPI

Christopher F Manacci, DNP, ACNP-C

  • Nurse Practitioner
  • Chagrin Falls, OH
National Provider Identifier
1063512796
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN191505 Issued in OH
Practice address
17819 Auburn Rd
Chagrin Falls, OH 44023-6130
Phone
(844) 764-4633
Fax
(310) 861-0855
NPI assigned
Sep 23, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN191505 OH Primary

Addresses

Primary practice location

17819 Auburn Rd
Chagrin Falls, OH 44023-6130

Mailing address

17819 Auburn Rd
Chagrin Falls, OH 44023-6130
Phone (844) 764-4633

Other identifiers 1

IdentifierTypeStateIssuer
2637758MedicaidOH

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN191505OHMDNurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063512796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17819 AUBURN RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440236130",
            "telephone_number": "844-764-4633",
            "fax_number": "310-861-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17819 AUBURN RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440236130",
            "telephone_number": "844-764-4633",
            "fax_number": "310-861-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANACCI",
        "first_name": "CHRISTOPHER",
        "middle_name": "F",
        "credential": "DNP, ACNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN191505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2637758",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.