Nicole Kelley Manning, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

236464 Issued in MA

Practice address

102 Shore Dr
Suite 403
Worcester, MA 01605-3154

Phone

(508) 856-0458

NPI assigned

Dec 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/74/brand/1/csg/1/fhir/r4

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.

• Shrewsbury OB/GYN, P.C.

  • Obstetrics & Gynecology Physician
  • Shrewsbury, MA
  • NPI 1013031376
  Medicare reassignment

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1457696015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BRENDAN DR",
            "city": "GRAFTON",
            "state": "MA",
            "postal_code": "015192000",
            "telephone_number": "508-887-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SHORE DR",
            "address_2": "SUITE 403",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053154",
            "telephone_number": "508-856-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "NICOLE",
        "middle_name": "KELLEY",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "236464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110096015A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Javed Mannan, M.D.
• Elizabeth Manney
• Joan B Mannick, M.D.
• Dana Manning, CRNA
• Mark J. Manning, D.O.
• Erin Marie Mannion, DPT
• Lourdes Maria Mannise
• Mariann M Manno, M.D.
• Shamitha Alisa Manohar, MD
• Manouch Darvish DMD PC

• Adult Health Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.

Verify at the official NPI Registry.