Individual provider Active NPI

Jean Ellen Manasco, PHARM-D

  • Pharmacist
  • Jasper, AL
National Provider Identifier
1184057929
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13922 Issued in AL
Practice address
201 19TH St E
Jasper, AL 35501-5457
Phone
(205) 387-1403
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13922 AL Primary

Addresses

Primary practice location

201 19TH St E
Jasper, AL 35501-5457

Mailing address

201 19TH St E
Jasper, AL 35501-5457
Phone (205) 387-1403

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
13922ALMDCritical Care Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1184057929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 19TH ST E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355015457",
            "telephone_number": "205-387-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 19TH ST E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355015457",
            "telephone_number": "205-387-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANASCO",
        "first_name": "JEAN",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PHARM-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "13922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.