Edgardo Angeles Manahan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009220 Issued in GA

Practice address

1013 Riverburch Pkwy
Suite 4
Dalton, GA 30721-8887

Phone

(866) 261-8090

Fax

(706) 226-7869

NPI assigned

Jul 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1376773937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 RIVERBURCH PKWY",
            "address_2": "SUITE 4",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218887",
            "telephone_number": "866-261-8090",
            "fax_number": "706-226-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 RIVERBURCH PKWY",
            "address_2": "SUITE 4",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218887",
            "telephone_number": "866-261-8090",
            "fax_number": "706-226-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAHAN",
        "first_name": "EDGARDO",
        "middle_name": "ANGELES",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Dalton, GA
• Providers in Dalton, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.