Kelly W Manning, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4838 Issued in SD

Practice address

353 Fairmont Blvd
Rapid City, SD 57701-7375

Phone

(605) 755-8222

Fax

(605) 719-4203

NPI assigned

Oct 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Monument Health Rapid City Hospital Inc

  dba Monument Health Rapid Valley Clinic

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD (past)
• Samaritan Emergency Corp

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1922084136
  NPD (past)

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1174613434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912882",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912882",
            "telephone_number": "866-765-0909",
            "fax_number": "855-856-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "605-755-8222",
            "fax_number": "605-719-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "KELLY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "4838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174613434",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1462447",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174613434",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Marie Maliske, PA-C
• Jan C Mangelsen, CNM
• Manlove Psychiatric Group, P.C.
• Stephen Paul Manlove, MD
• Tara Mann, CDCT
• Nicholas Mantei, PA-C
• Amy Mantie, PT
• Tristan Rae Marchant, LCSW
• Ilya Marchenko, DMD
• Dean R Marietta, M.D.

• Emergency Medicine Physician in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Emergency Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.