Individual provider Active NPI

Gregory Keith Manley, RPH

  • Pharmacist
  • Butler, AL
National Provider Identifier
1184711152
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10377 Issued in AL
Practice address
604 E Pushmataha St
Butler, AL 36904-2620
Phone
(205) 459-2990
NPI assigned
Oct 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10377 AL Primary
Pharmacist 183500000X E-07032 MS

Addresses

Primary practice location

604 E Pushmataha St
Butler, AL 36904-2620

Mailing address

2790 Needham Rd
Needham, AL 36915-3001
Phone (205) 673-2820

Other identifiers 2

IdentifierTypeStateIssuer
10377OtherALPHARMACIST LICENSE
E-07032OtherMSMS PHARMACIST LICENSE

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
10377ALMDPharmacist
E-07032MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mr Discount Drugs of Butler Past Accepting new patients
Mr Discount Drugs of Butler 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184711152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 NEEDHAM RD",
            "city": "NEEDHAM",
            "state": "AL",
            "postal_code": "369153001",
            "telephone_number": "205-673-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E PUSHMATAHA ST",
            "city": "BUTLER",
            "state": "AL",
            "postal_code": "369042620",
            "telephone_number": "205-459-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "GREGORY",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "10377",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-07032",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "10377",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS PHARMACIST LICENSE",
            "identifier": "E-07032",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.