Individual provider Active NPI

Carol Manning, MD

  • Diagnostic Radiology Physician
  • Long Beach, CA
National Provider Identifier
1154346336
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G40306 Issued in CA
Practice address
3320 N Los Coyotes Diagonal
Suite 120, 112 & 260
Long Beach, CA 90808-3918
Phone
(562) 627-0903
Fax
(562) 627-0923
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G40306 CA Primary

Addresses

Primary practice location

3320 N Los Coyotes Diagonal
Suite 120, 112 & 260
Long Beach, CA 90808-3918

Mailing address

1160 Pittsford Victor Rd
D-2
Pittsford, NY 14534-3825
Phone (585) 218-8007

Other identifiers 2

IdentifierTypeStateIssuer
00G403060MedicaidCA
00G403060OtherCABLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
G40306CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Past Accepting new patients
Robin K Dore MD Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1154346336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 PITTSFORD VICTOR RD",
            "address_2": "D-2",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145343825",
            "telephone_number": "585-218-8007",
            "fax_number": "585-218-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 N LOS COYOTES DIAGONAL",
            "address_2": "SUITE 120, 112 & 260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908083918",
            "telephone_number": "562-627-0903",
            "fax_number": "562-627-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G40306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G403060",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G403060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.