Individual provider Active NPI

David Lonnie Maness, D.O.

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1093705576
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO000623 Issued in TN
Practice address
294 Summar Dr
Jackson, TN 38301-3915
Phone
(731) 423-1932
Fax
(731) 410-0367
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28293 GA
Family Medicine Physician 207Q00000X DO000623 TN Primary
Family Medicine Physician 207Q00000X 0200 SC

Addresses

Primary practice location

294 Summar Dr
Jackson, TN 38301-3915

Mailing address

294 Summar Dr
Jackson, TN 38301-3915
Phone (731) 423-1932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070904000648 TN Practitioner - Family Practice 4587757794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Physicians and Surgeons (Iowa), 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WT University Medical Associates IncGroup PAC ID 3779824719, 14 clinicians

Practice addresses (Care Compare)

294 Summar Dr
Jackson, TN 38301-3915
Phone (731) 423-1932

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28293GAMDFamily Medicine Physician
0200SCMDFamily Medicine Physician
DO000623TNMDFamily Medicine Physician
623TNMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Tennessee CurrentSince Apr 1, 2008 Accepting new patients
University of Tennessee Family Medicine CurrentSince Apr 1, 2008 Accepting new patients
WT University Medical Associates Inc Family Medicine CurrentSince Apr 1, 2019 Accepting new patients

Locations

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

700 W Forest Ave
Fl 5
Jackson, TN 38301
Phone (731) 423-1932

31 Physicians Dr
Jackson, TN 38305
Phone (731) 285-5133

700 W Forest Ave
#5
Jackson, TN 38301

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

1301 Primacy Pkwy
Memphis, TN 38119
Phone (901) 448-0230

Interoperability endpoints

  • Direct secure messaging: dmaness18768@directepic.wth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1093705576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANESS",
        "first_name": "DAVID",
        "middle_name": "LONNIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "28293",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO000623",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "0200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.