Jackie Renee Manning, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11001650 Issued in FL

Practice address

789 W Duval St
Lake City, FL 32055-3811

Phone

(386) 755-5044

NPI assigned

Mar 26, 2019

Last updated

Mar 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20870/brand/1/csg/1/fhir/r4

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.

• Foland Chiropractic & Spa, Inc.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1598992240
  Medicare reassignment NPD
• Strive Integrated Physical Medicine LLC

  • Physical Medicine & Rehabilitation Physician
  • Ocala, FL
  • NPI 1467855940
  Medicare reassignment NPD
• Active Chiropractic Wellness Center, LLC

  • Chiropractor
  • Jacksonville, FL
  • NPI 1982850830
  Medicare reassignment
• Andres R Villar MD

  dba Children's Medical Center

  • Pediatrics Physician
  • Glen St Mary, FL
  • NPI 1689768772
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1265993091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 E OHIO AVE",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632137",
            "telephone_number": "904-545-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 W DUVAL ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553811",
            "telephone_number": "386-755-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "JACKIE",
        "middle_name": "RENEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Bennett Mahan II, RRT
• Heather Marie Mahoney, LCSW
• Lauren Maloney, MSCAP
• Patrick Maltba
• Emmalee Diane Manning
• Jennifer Manning
• Lindsey Manning
• Amanda Manske, LCSW, RPT
• Rizwan Mansoor, MD
• Berge Marcarian, M.D.

• Family Nurse Practitioner in Lake City, FL
• Providers in Lake City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.