Active NPI
Ernesto Manuel, M.D.
- Family Medicine Physician
- Logan, WV
National Provider Identifier
1114981024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 14503
- Practice address
- 396 Dingess St
Logan, WV 25601-3624 - Phone
- (304) 831-1700
- Fax
- (304) 831-1726
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 14503 | WV | Primary |
Addresses
Primary practice location
396 Dingess St
Logan, WV 25601-3624
Mailing address
396 Dingess St
Logan, WV 25601-3624
Phone (304) 831-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0057545000 | Medicaid | WV |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elm Emergency Group PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Logan, WV
- NPI 1447400734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1114981024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "396 DINGESS ST",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013624",
"telephone_number": "304-831-1700",
"fax_number": "304-831-1726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "396 DINGESS ST",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013624",
"telephone_number": "304-831-1700",
"fax_number": "304-831-1726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANUEL",
"first_name": "ERNESTO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "14503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0057545000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Logan, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.