Individual provider Active NPI

Eric R Manahan, M.D.

  • Surgery Physician
  • Dalton, GA
National Provider Identifier
1295785194
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
048916 Issued in GA
Practice address
1504 Broadrick Dr
Dalton, GA 30720-3011
Phone
(706) 278-6403
Fax
(706) 278-0087
NPI assigned
May 11, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 048916 GA Primary

Addresses

Primary practice location

1504 Broadrick Dr
Dalton, GA 30720-3011

Mailing address

1504 Broadrick Dr
Dalton, GA 30720-3011
Phone (706) 278-6403

Other identifiers 1

IdentifierTypeStateIssuer
00872374BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110407000903 GA Practitioner - General Surgery 2961397831 Reassigns benefits to 2 organizations
I20260605002817 AL Practitioner - General Surgery 2961397831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
East Tennessee State University Quillen College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Physician Group, IncGroup PAC ID 4789708553, 120 clinicians

Practice addresses (Care Compare)

1504 Broadrick Dr
Dalton, GA 30720-3011
Phone (706) 278-6403

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 528-6610

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy22
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Jul 16, 2018 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Oct 11, 2023 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Oct 11, 2023 Accepting new patients
Hamilton Medical Center, Inc. Past Accepting new patients

Locations

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

920 18th St
Columbus, GA 31901
Phone (404) 649-6600

1436 Broadrick Dr
Ste B
Dalton, GA 30720
Phone (706) 226-3434

1504 Broadrick Dr
Dalton, GA 30720
Phone (706) 278-6403

Interoperability endpoints

  • Direct secure messaging: emanahan18498@hhcs.direct-ci.com

Organizations & group practices 5

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 4

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1295785194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203011",
            "telephone_number": "706-278-6403",
            "fax_number": "706-278-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203011",
            "telephone_number": "706-278-6403",
            "fax_number": "706-278-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAHAN",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "048916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00872374B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.