Organization Active NPI

Manning Regional Healthcare Center

Doing business as Manning Regional Healthcare Clinic

  • Family Medicine Physician
  • Manning, IA
National Provider Identifier
1235432196
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MANNING REGIONAL HEALTHCARE CENTER
Doing business as
Manning Regional Healthcare Clinic
Practice address
1550 6TH St
Manning, IA 51455-1004
Phone
(712) 655-2072
Fax
(712) 655-3330
NPI assigned
Dec 15, 2010
Last updated
Feb 27, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MANNING REGIONAL HEALTHCARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Authorized official

Name
John O'Brien
Title
Ceo
Phone
(712) 655-2072

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1550 6TH St
Manning, IA 51455-1004

Mailing address

1550 6TH St
Manning, IA 51455-1004
Phone (712) 655-2072

Other names 1

  • Manning Regional Healthcare Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001163 IA Part B Supplier - Clinic/Group Practice 7618960840 Receives reassigned benefits from 31 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manning, IA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Manning Reg Hlthcare Center

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1235432196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 6TH ST",
            "city": "MANNING",
            "state": "IA",
            "postal_code": "514551004",
            "telephone_number": "712-655-2072",
            "fax_number": "712-655-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 6TH ST",
            "city": "MANNING",
            "state": "IA",
            "postal_code": "514551004",
            "telephone_number": "712-655-2072",
            "fax_number": "712-655-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNING REGIONAL HEALTHCARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANNING REGIONAL HEALTHCARE CENTER",
        "enumeration_date": "2010-12-15",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-655-2072"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manning Regional Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manning, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.