Cody Anthony Manzanero, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LL92154 Issued in SC

Practice address

169 Ashley Avenue
Room 202 Main Hospital, Msc333
Charleston, SC 29425

Phone

(843) 792-2575

NPI assigned

Jun 4, 2024

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1275374233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANERO",
        "first_name": "CODY",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL92154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Mansell, DO
• Jonathan Mansfield, PHARMD
• Deanna Rochelle Mansker, M.D.
• Maegan Elizabeth Manson, APN-C
• Casey Manya, LMSW
• Carolyn Manzi, LPC
• Andrew M Mappus, RN
• Elliott Dickson Mappus, MD
• Anbukarasi Maran, M.B.B.S
• Harshita Marasandra Ramesh, M.B.B.S

• Family Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.