Bruce K. Manley, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2001003634 Issued in MO

Practice address

8350 N Saint Clair Ave
Suite 250
Kansas City, MO 64151-5100

Phone

(816) 223-6128

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2019 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1306977426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 NW EDGEWOOD TRL",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641513393",
            "telephone_number": "816-223-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 N SAINT CLAIR AVE",
            "address_2": "SUITE 250",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641515100",
            "telephone_number": "816-223-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "BRUCE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2001003634",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LP-0999",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MO",
            "license": "2001003634",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NON-PROVIDER #",
            "identifier": "27031028",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita A Mangold, RN
• Mangus Chiropractic & Wellness LLC
• Shivarajan Manickavasagam Amudhavalli, M.B.B.S.
• Winston Manimtim, M.D.
• Amanda Marie Manke, OTR, MSOT
• Francis J. Manley, PH.D.
• Addie Lee Manlove
• Christin Shirley Mann, APRN
• Keith Justin Mann, MD
• Margaret Emma Mann, MD

• Psychologist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.