Henry A Manning, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003255 Issued in GA

Practice address

2400 Bellevue Rd
16 Erin Ofc Park
Dublin, GA 31021-2885

Phone

(478) 275-7546

NPI assigned

Sep 2, 2005

Last updated

Mar 12, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Medical College of Georgia School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Georgia Dermatology & Skin Cancer Center, LLC

  • Dermatology Physician
  • Dublin, GA
  • NPI 1063460459
  Medicare reassignment Care Compare group
• Georgia Dermatology &Skin Cancer Center, PC

  • Dermatology Physician
  • Macon, GA
  • NPI 1447363346
  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1164416335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "SUITE 21-A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-275-7202",
            "fax_number": "478-274-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "16 ERIN OFC PARK",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-275-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "HENRY",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003255",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003255",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "003255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC4061",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "553969817C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anju Malla, M.D
• Mann Medical Complex
• Phyllis Mary Mann, LPN
• Qwuayana Manner, CPHT
• Heather Joiner Manning, COTA/L
• Mikaela Mantele, PTA
• Anthony Margiotta Jr., LMSW
• Mark a Everson Medical Supply
• Mark L. Boles, MD (Dublin Women's Center)
• Danielle Paige Martin, NP-C

• Physician Assistant in Dublin, GA
• Providers in Dublin, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.