Active NPI
Alice Bertha Manley, ARNP
- Pediatric Nurse Practitioner
- Auburndale, FL
National Provider Identifier
1477541936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP127374
- Practice address
- 1805 Hobbs Rd
Auburndale, FL 33823-4644 - Phone
- (863) 965-5400
- Fax
- (863) 965-3739
- NPI assigned
- Oct 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | ARNP127374 | FL | Primary |
Addresses
Primary practice location
1805 Hobbs Rd
Auburndale, FL 33823-4644
Mailing address
1290 Golfview Ave
4TH Floor Attn Billing Department
Bartow, FL 33830-6738
Phone (863) 519-7900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 034043000 | Medicaid | FL |
Other names 1
- Alice Bertha Stanfield
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP127374 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Service Association Inc | Past | Accepting new patients | |
| Florida Department of Health | Past | Accepting new patients | |
| Florida Department of Health | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Public Health or Welfare Agency
- Bronson, FL
- NPI 1154395390
-
- Public Health or Welfare Agency
- Lakeland, FL
- NPI 1396732541
-
- Neurological Surgery Physician
- Tampa, FL
- NPI 1740227966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1477541936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 GOLFVIEW AVE",
"address_2": "4TH FLOOR ATTN BILLING DEPARTMENT",
"city": "BARTOW",
"state": "FL",
"postal_code": "338306738",
"telephone_number": "863-519-7900",
"fax_number": "863-519-7696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 HOBBS RD",
"city": "AUBURNDALE",
"state": "FL",
"postal_code": "338234644",
"telephone_number": "863-965-5400",
"fax_number": "863-965-3739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANLEY",
"first_name": "ALICE",
"middle_name": "BERTHA",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-10",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP127374",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "034043000",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ALICE",
"last_name": "STANFIELD",
"middle_name": "BERTHA",
"credential": "ARNP",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Auburndale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.