Individual provider Active NPI

Justin Manning

  • Pharmacist
  • West Des Moines, IA
National Provider Identifier
1417487885
Registry record updated Jun 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5773 Issued in SD
Practice address
5820 Westown Pkwy
West Des Moines, IA 50266-8223
Phone
(515) 267-7894
NPI assigned
Jun 18, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5773 SD Primary

Addresses

Primary practice location

5820 Westown Pkwy
West Des Moines, IA 50266-8223

Mailing address

5820 Westown Pkwy
West Des Moines, IA 50266-8223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5773SDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1417487885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668223",
            "telephone_number": "515-267-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "5773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; 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.