Organization Active NPI

Ludmil Manov MD PC

  • Psychiatry Physician
  • American Fork, UT
National Provider Identifier
1275959546
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LUDMIL MANOV MD PC
Practice address
21 N 490 W
American Fork, UT 84003-2264
Phone
(801) 642-2396
Fax
(801) 642-2496
NPI assigned
Mar 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Ludmil ManovNPI 1629098108
Title
Owner
Phone
(801) 642-2396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

21 N 490 W
American Fork, UT 84003-2264

Mailing address

21 N 490 W
American Fork, UT 84003-2264
Phone (801) 642-2396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140723001555 UT Part B Supplier - Clinic/Group Practice 6204052558 Receives reassigned benefits from 1 practitioner
Practice locations: American Fork, UT

National Provider Directory

National Provider Directory

Locations

21 N 490 W
American Fork, UT 84003
Phone (801) 592-7876

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1275959546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N 490 W",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032264",
            "telephone_number": "801-642-2396",
            "fax_number": "801-642-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N 490 W",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032264",
            "telephone_number": "801-642-2396",
            "fax_number": "801-642-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUDMIL MANOV MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "MANOV",
        "authorized_official_first_name": "LUDMIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-642-2396"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.