Theodis Roosevelt Manning, B.S. ENGINEERING

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

8306 NE 10TH St
Midwest City, OK 73110-7155

Phone

(405) 732-0573

NPI assigned

Aug 1, 2011

Last updated

Apr 5, 2024By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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.

• Another Chance Counseling Agency, Inc

  • Community/Behavioral Health Agency
  • Midwest City, OK
  • NPI 1225316003
  NPD (past)

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1225316706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8306 NE 10TH ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731107155",
            "telephone_number": "405-732-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8306 NE 10TH ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731107155",
            "telephone_number": "405-732-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "THEODIS",
        "middle_name": "ROOSEVELT",
        "name_prefix": "Mr.",
        "credential": "B.S. ENGINEERING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "00000000000000000000",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suneel Makineni, DDS
• Jahanyar John Makipour, Jr, MD
• Evelyn Maldonado
• Felicia Ann Manning
• Theodis Manning
• Manor Care of Midwest City Ok LLC (ManorCare Health Services - Midwest)
• Benjamin Panagiotis Mansalis, M.D.
• Jenell Mapp
• Makenna Marchbanks
• Taylor Clinton Marcum

• Peer Specialist in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.