Individual provider Active NPI

Robert Daniel Maner, D.O.

  • Emergency Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1417488925
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4446 Issued in TN
Practice address
725 Glenwood Dr Ste E487
Chattanooga, TN 37404-1173
Phone
(423) 697-0014
Fax
(234) 648-6280
NPI assigned
Mar 26, 2017
Last updated
Aug 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Emergency Medicine Physician 207P00000X 4446 TN Primary

Addresses

Primary practice location

725 Glenwood Dr Ste E487
Chattanooga, TN 37404-1173

Mailing address

36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 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
I20210716000207 GA Practitioner - Emergency Medicine 9234403981 Reassigns benefits to 4 organizations
I20211020000224 TN Practitioner - Emergency Medicine 9234403981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Union Emergency Medical Services, LLCGroup PAC ID 8224308770, 26 clinicians

Practice addresses (Care Compare)

35 Hospital Rd
Blairsville, GA 30512-3139
Phone (706) 745-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4446TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Emergency Medical Services Consolidated, LLC CurrentSince Jun 8, 2021 Accepting new patients
Southland Union Emergency Medical Services, LLC CurrentSince Jun 8, 2021 Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Jul 1, 2021 Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Mar 20, 2022 Accepting new patients
Southland Chatuge Emergency Medical Services, LLC Emergency Medicine CurrentSince Jun 8, 2021 Accepting new patients

Locations

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301

110 S Main St
Hiawassee, GA 30546
Phone (706) 896-2222

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

725 Glenwood Dr
Ste E487
Chattanooga, TN 37404
Phone (423) 697-0014

Interoperability endpoints

  • Direct secure messaging: rmaner243012@direct.stlukeshealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1417488925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36475 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-655-4800",
            "fax_number": "734-655-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR STE E487",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041173",
            "telephone_number": "423-697-0014",
            "fax_number": "234-648-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANER",
        "first_name": "ROBERT",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "4446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.