Individual provider Active NPI

Russell E Manney III, D.C.

  • Chiropractor
  • Westmont, IL
National Provider Identifier
1316954803
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
812 E Ogden Ave
Westmont, IL 60559-1246
Phone
(630) 655-9380
NPI assigned
Aug 1, 2006
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

812 E Ogden Ave
Westmont, IL 60559-1246

Mailing address

1516 Stewart Dr
Darien, IL 60561-5907
Phone (630) 910-1140

Other identifiers 2

IdentifierTypeStateIssuer
7476704OtherILAETNA
02232677OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000909 IL Practitioner - Chiropractic 5991751588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Centers LTDGroup PAC ID 0648226233, 3 clinicians

Practice addresses (Care Compare)

812 E Ogden Ave
Westmont, IL 60559-1246
Phone (630) 655-9380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010311ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Centers LTD Chiropractor CurrentSince Feb 1, 2005 Accepting new patients

Locations

930 N York Rd
Ste 50
Hinsdale, IL 60521
Phone (630) 214-9716

812 E Ogden Ave
Westmont, IL 60559
Phone (630) 455-1900

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1316954803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 STEWART DR",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615907",
            "telephone_number": "630-910-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591246",
            "telephone_number": "630-655-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNEY",
        "first_name": "RUSSELL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7476704",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02232677",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.