Active NPI
Justin Leonard Manning, O.D.
- Optometrist
- Colorado Springs, CO
National Provider Identifier
1164863734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 00003278
- Practice address
- 9205 N Union Blvd
Suite 110
Colorado Springs, CO 80920-7830 - Phone
- (719) 282-0400
- Fax
- (719) 282-1004
- NPI assigned
- Jul 11, 2013
- Last updated
- Aug 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 60378496 | WA | |
| Optometrist | 152W00000X | 00003278 | CO | Primary |
Addresses
Primary practice location
9205 N Union Blvd
Suite 110
Colorado Springs, CO 80920-7830
Mailing address
9205 N Union Blvd
Suite 110
Colorado Springs, CO 80920-7830
Phone (719) 282-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164863734 | Medicaid | WA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00003278 | CO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Binyon Optometrists, Inc .PS | Optometrist | Current | Accepting new patients |
| Binyon Vision Bellingham PLLC | Optometrist | Current | Accepting new patients |
| David Thomas Williams | Optometrist | Past | Accepting new patients |
Locations
411 E Magnolia St
Bellingham, WA 98225
Phone (360) 647-2020
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Bellingham, WA
- NPI 1245412014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1164863734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9205 N UNION BLVD",
"address_2": "SUITE 110",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809207830",
"telephone_number": "719-282-0400",
"fax_number": "719-282-1004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9205 N UNION BLVD",
"address_2": "SUITE 110",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809207830",
"telephone_number": "719-282-0400",
"fax_number": "719-282-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "JUSTIN",
"middle_name": "LEONARD",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-11",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "60378496",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "00003278",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1164863734",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.