Individual provider Active NPI

Kim H Manwaring, M.D.

  • Neurological Surgery Physician
  • Orlando, FL
National Provider Identifier
1336100460
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME115953 Issued in FL
Practice address
92 W Miller St
Orlando, FL 32806-2032
Phone
(321) 841-2032
Fax
(321) 843-3570
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 13310 AZ
Neurological Surgery Physician 207T00000X 21094 NH
Neurological Surgery Physician 207T00000X ME115953 FL Primary

Addresses

Primary practice location

92 W Miller St
Orlando, FL 32806-2032

Mailing address

92 W Miller St
Orlando, FL 32806-2032
Phone (321) 841-2032

Other practice location 1

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (321) 841-3050

Other practice location 2

1 Medical Dr
Lebanon, NH 03756-1000
Phone (603) 650-5109

Other identifiers 2

IdentifierTypeStateIssuer
251819MedicaidAZ
009357100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DE2 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
I20130730000256 FL Practitioner - NeurosurgeryPractitioner - Pediatric Medicine 4688611767 Reassigns benefits to 2 organizations
I20240426001775 DE Practitioner - Neurology 4688611767 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Neurological Surgery CurrentSince Sep 1, 2018 Accepting new patients
The Nemours Foundation CurrentSince Jun 5, 2013 Accepting new patients
The Nemours Foundation CurrentSince Feb 24, 2024 Accepting new patients
The Nemours Foundation Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2018 Accepting new patients
The Nemours Foundation CurrentSince Jun 5, 2013 Accepting new patients
Neurosurgical Associates, LTD Neurological Surgery Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

Interoperability endpoints

  • Direct secure messaging: kmanwaring420709@direct.dartmouth-hitchcock.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1336100460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-2032",
            "fax_number": "321-843-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-2032",
            "fax_number": "321-843-3570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 S Orange Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061215",
            "country_code": "US",
            "telephone_number": "321-841-3050",
            "fax_number": "321-843-3570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-5109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANWARING",
        "first_name": "KIM",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "13310",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NH",
            "license": "21094",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME115953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251819",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009357100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.