Individual provider Active NPI

Jillian Manng, AGNP-C

  • Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1346779626
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP10152 Issued in AZ
Practice address
11000 N. Scottsdale Rd.
#145
Scottsdale, AZ 85254
Phone
(480) 607-0606
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP10152 AZ Primary

Addresses

Primary practice location

11000 N. Scottsdale Rd.
#145
Scottsdale, AZ 85254

Mailing address

11000 N Scottsdale Rd Ste 145
Scottsdale, AZ 85254-5102
Phone (480) 607-0606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104002886 AZ Practitioner - Nurse Practitioner 7517358336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

19636 N 27TH Ave
Phoenix, AZ 85027-4021

19636 N 27TH Ave
Suite 201
Phoenix, AZ 85027-4015
Phone (623) 516-4400

33300 N 32ND Ave
Suite 205
Phoenix, AZ 85085-8877
Phone (602) 962-0071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10152AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory CurrentSince Jan 24, 2022 Accepting new patients
Honorhealth Ambulatory CurrentSince Jan 24, 2022 Accepting new patients
Phoenician Hospice LLC PastSince Jan 1, 2020 Accepting new patients
Honorhealth Ambulatory Past Accepting new patients

Locations

19636 N 27th Ave
Ste 408
Phoenix, AZ 85027
Phone (623) 780-0100

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

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.

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346779626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 N SCOTTSDALE RD STE 145",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545102",
            "telephone_number": "480-607-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 N. SCOTTSDALE RD.",
            "address_2": "#145",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85254",
            "telephone_number": "480-607-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNG",
        "first_name": "JILLIAN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.