Individual provider Active NPI

Jeffrey T Manning, M.D.

  • Anesthesiology Physician
  • Waco, TX
National Provider Identifier
1235228784
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M1224 Issued in TX
Practice address
405 Londonderry Dr
Suite 105
Waco, TX 76712-7924
Phone
(254) 776-0266
Fax
(254) 776-2511
NPI assigned
Oct 12, 2006
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X M1224 TX Primary

Addresses

Primary practice location

405 Londonderry Dr
Suite 105
Waco, TX 76712-7924

Mailing address

PO Box 224137
Dallas, TX 75222-4137
Phone (254) 776-0266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919000772 TX Practitioner - Anesthesiology 5799718169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical School at Houston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Tex Anesthesia Associates, P.a.Group PAC ID 5395815369, 28 clinicians

Practice addresses (Care Compare)

405 Londonderry Dr
Suite 105
Waco, TX 76712-7920
Phone (254) 776-0266

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M1224TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Anesthesiology CurrentSince Jan 3, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 3, 2022 Accepting new patients
Jeffrey T Manning MD PA Anesthesiology PastSince May 5, 2005 Accepting new patients

Locations

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascension ProvidenceWaco, TX, CCN 450042 Hospital Corporate Director Jul 1, 2020
Ascension Seton Highland LakesBurnet, TX, CCN 451365 Hospital Corporate Director Jul 1, 2020
Ascension Seton SmithvilleSmithville, TX, CCN 67Z304 Hospital Corporate Director Jul 1, 2020
Ascension Seton Bertram Health CenterBertram, TX, CCN 458876 Rural health clinic Other Jul 1, 2020
Ascension Seton Kingsland Health CenterKingsland, TX, CCN 673450 Rural health clinic Corporate Director Jul 1, 2020
Ascension Seton Luling Health CenterLuling, TX, CCN 673449 Rural health clinic Corporate Director Jul 1, 2020
Ascension Seton Lockhart Health Center CommerceLockhart, TX, CCN 673463 Rural health clinic Corporate Director Jul 1, 2020
Ascension Seton Lockhart Health Center ChurchLockhart, TX, CCN 673462 Rural health clinic Corporate Director Jul 1, 2020
Ascension Seton Bastrop Health CenterBastrop, TX, CCN 673470 Rural health clinic Corporate Director Jul 1, 2020
Ascension Seton Dripping Springs Health CenterDripping Springs, TX, CCN 678549 Rural health clinic Corporate Director Jul 1, 2020

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1235228784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 224137",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752224137",
            "telephone_number": "254-776-0266",
            "fax_number": "254-776-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127924",
            "telephone_number": "254-776-0266",
            "fax_number": "254-776-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M1224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.