Active NPI
Pamella Norva Manners, CAC-AD
- Addiction (Substance Use Disorder) Counselor
- Essex, MD
National Provider Identifier
1104434927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- AC2110
- Practice address
- 8909 Kelso Dr
Essex, MD 21221-3113 - Phone
- (410) 486-2500
- Fax
- (410) 780-8686
- NPI assigned
- Jul 17, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AC2110 | MD | Primary |
Addresses
Primary practice location
8909 Kelso Dr
Essex, MD 21221-3113
Mailing address
8909 Kelso Drive, Essex, MD 21221
Essex, MD 21221
Phone (410) 486-2500
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | MedMark-Essex | Health Information Exchange (HIE) | |
| CONNECT URL | pmanners@medmark.com | Health Information Exchange (HIE) |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC2110 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1104434927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8909 KELSO DRIVE, ESSEX, MD 21221",
"city": "ESSEX",
"state": "MD",
"postal_code": "21221",
"telephone_number": "410-486-2500",
"fax_number": "410-780-8686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8909 KELSO DR",
"city": "ESSEX",
"state": "MD",
"postal_code": "212213113",
"telephone_number": "410-486-2500",
"fax_number": "410-780-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNERS",
"first_name": "PAMELLA",
"middle_name": "NORVA",
"name_prefix": "Ms.",
"credential": "CAC-AD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-17",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "AC2110",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "MedMark-Essex",
"affiliation": "N",
"endpointDescription": "MedMark is a treatment in Essex,MD 21221",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "By Fax or e-mail",
"address_1": "8909 Kelso Dr",
"city": "Essex",
"state": "MD",
"country_code": "US",
"postal_code": "212213113",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "pmanners@medmark.com",
"affiliation": "N",
"endpointDescription": "Fax :410: 780-8686",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Fax or e-mail",
"address_1": "8909 Kelso Dr",
"city": "Essex",
"state": "MD",
"country_code": "US",
"postal_code": "212213113",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Essex, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.