Active NPI
Evan Manning, MD
- Rheumatology Physician
- Keesler AFB, MS
National Provider Identifier
1386140309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 84637
- Practice address
- 301 Fisher St
Keesler AFB, MS 39534-2508 - Phone
- (228) 376-2273
- NPI assigned
- Mar 30, 2018
- Last updated
- Jul 30, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Rheumatology Physician | 207RR0500X | 84637 | GA | Primary |
| General Practice Physician | 208D00000X | 84637 | GA |
Addresses
Primary practice location
301 Fisher St
Keesler AFB, MS 39534-2508
Mailing address
301 Fisher St
Keesler AFB, MS 39534-2508
Other practice location 1
3551 Roger Brooke Dr., JBSA-Fort Sam Houston
SAMMC, MCHE-ZDM-M, Internal Medicine Residency
San Antonio, TX 78234-4504
Phone (210) 292-5077
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200514000032 | GA | Order and Referring Only - Internal Medicine | 4183055817 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753833600000",
"number": "1386140309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 FISHER ST",
"city": "KEESLER AFB",
"state": "MS",
"postal_code": "395342508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 FISHER ST",
"city": "KEESLER AFB",
"state": "MS",
"postal_code": "395342508",
"telephone_number": "228-376-2273"
}
],
"practiceLocations": [
{
"address_1": "3551 Roger Brooke Dr., JBSA-Fort Sam Houston",
"address_2": "SAMMC, MCHE-ZDM-M, Internal Medicine Residency",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782344504",
"country_code": "US",
"telephone_number": "210-292-5077",
"fax_number": "210-292-7868",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANNING",
"first_name": "EVAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-30",
"last_updated": "2025-07-30",
"certification_date": "2025-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "GA",
"license": "84637",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "GA",
"license": "84637",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keesler AFB, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.