Individual provider Active NPI

Casianne Abigail Manning

  • Family Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1427637305
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
110573 Issued in GA
Practice address
5462 Memorial Dr Ste 202
Stone Mountain, GA 30083-3239
Phone
(404) 292-5676
Fax
(404) 299-8657
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 110573 GA Primary

Addresses

Primary practice location

5462 Memorial Dr Ste 202
Stone Mountain, GA 30083-3239

Mailing address

5462 Memorial Dr Ste 202
Stone Mountain, GA 30083-3239
Phone (404) 292-5676

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260105002946 GA Practitioner - Family Practice 6507352002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

4703 Roaring Run Rd
Gillett, PA 16925-9691

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110573GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qcpi-Villagemd, PC Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

5435 Five Forks Trickum Rd
Stone Mountain, GA 30087
Phone (678) 732-1514

1805 Parke Plaza Cir
Ste 101
Stone Mtn, GA 30087
Phone (770) 469-7000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1427637305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 MEMORIAL DR STE 202",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833239",
            "telephone_number": "404-292-5676",
            "fax_number": "404-299-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 MEMORIAL DR STE 202",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833239",
            "telephone_number": "404-292-5676",
            "fax_number": "404-299-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "CASIANNE",
        "middle_name": "ABIGAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "110573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.