NPIMap

Individual provider Active NPI

Jeffrey Derrick Manord, M.D.

  • Vascular Surgery Physician
  • Russellville, AL
National Provider Identifier
1275587552
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
23436 Issued in AL
Practice address
15225 Highway 43 Ste D
Russellville, AL 35653-1969
Phone
(256) 332-1500
Fax
(256) 398-8888
NPI assigned
May 20, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD23436 AL
Vascular Surgery Physician 2086S0129X 23436 AL Primary

Addresses

Primary practice location

15225 Highway 43 Ste D
Russellville, AL 35653-1969

Mailing address

PO Box 660
Russellville, AL 35653-0616
Phone (256) 332-1500

Other practice location 1

203 Avalon Ave Ste 120
Muscle Shoals, AL 35661-2857
Phone (256) 332-1500

Other identifiers 2

IdentifierTypeStateIssuer
511-17526OtherALBCBS OF ALABAMA
126779MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071026000329 AL Practitioner - Vascular SurgeryPractitioner - General Surgery 6800891045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Alabama School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15225 Hwy 43
Suite D
Russellville, AL 35653-1969
Phone (256) 332-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.11 of 100Reported as individual
Quality
88.55
Improvement activities
40
Cost
78.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy63
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux56
Varicose vein removal1-10
Melanoma (skin cancer) excision18
Leg revascularization (restoring blood flow)20
Removal of tissue170
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23436ALMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General and Vascular Surgery of Northwest Alabma, Inc. Vascular Surgery CurrentSince Mar 1, 2011 Accepting new patients
Russellville Hospital Inc. Past Accepting new patients
University of South Alabama Health Services Foundation Past Accepting new patients

Locations

203 Avalon Ave
Ste 120
Muscle Shoals, AL 35661
Phone (256) 332-1500

15225 Highway 43
Ste D
Russellville, AL 35653
Phone (256) 332-1500

255 Medical Dr
#4
Winfield, AL 35594
Phone (205) 487-7800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEIFBD/Endpoint/IEIFBD
  • Direct secure messaging: jeffrey.manord@gvsonai.eclinicaldirectplus.com

Organizations & group practices 3

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 12

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1275587552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530616",
            "telephone_number": "256-332-1500",
            "fax_number": "256-398-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 HIGHWAY 43 STE D",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531969",
            "telephone_number": "256-332-1500",
            "fax_number": "256-398-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Avalon Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Muscle Shoals",
            "state": "AL",
            "postal_code": "356612857",
            "country_code": "US",
            "telephone_number": "256-332-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANORD",
        "first_name": "JEFFREY",
        "middle_name": "DERRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "MD23436",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AL",
            "license": "23436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "511-17526",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126779",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AL

Sources for this page

Verify at the official NPI Registry.