NPIMap

Individual provider Active NPI

Manon Childers, M.D.

  • Family Medicine Physician
  • Perryton, TX
National Provider Identifier
1487614228
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G4911 Issued in TX
Practice address
3101 Garrett Dr
Perryton, TX 79070-5323
Phone
(806) 435-3606
Fax
(806) 435-2067
NPI assigned
Mar 24, 2006
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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 G4911 TX Primary

Addresses

Primary practice location

3101 Garrett Dr
Perryton, TX 79070-5323

Mailing address

3006 Garrett Dr
Perryton, TX 79070-5322
Phone (806) 435-6856

Other practice location 1

3006 Garrett Dr
Perryton, TX 79070-5322
Phone (806) 435-6856

Other identifiers 1

IdentifierTypeStateIssuer
132970803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000598 TX Practitioner - Family Practice 0345347852 Reassigns benefits to 5 organizations
Practice locations: Perryton, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochiltree Hospital DistrictGroup PAC ID 0749257723, 15 clinicians

Practice addresses (Care Compare)

3101 Garrett Dr
Perryton, TX 79070-5323
Phone (806) 435-3606

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G4911TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochiltree Hospital District Current Accepting new patients
Dallam-Hartley Counties Hospital District Family Medicine CurrentSince Feb 3, 2024 Accepting new patients
Dallam-Hartley Counties Hospital District CurrentSince Feb 3, 2024 Accepting new patients
Texas Emergency Group LLC CurrentSince Mar 1, 2022 Accepting new patients
Ochiltree Hospital District CurrentSince Jul 6, 2013 Accepting new patients

Locations

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

1411 Denver Ave
Dalhart, TX 79022
Phone (806) 244-4571

3101 Garrett Dr
Perryton, TX 79070
Phone (806) 435-3606

3101 Garrett Dr
Rm Phys
Perryton, TX 79070

Organizations & group practices 7

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 3

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1487614228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 GARRETT DR",
            "city": "PERRYTON",
            "state": "TX",
            "postal_code": "790705322",
            "telephone_number": "806-435-6856",
            "fax_number": "806-435-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 GARRETT DR",
            "city": "PERRYTON",
            "state": "TX",
            "postal_code": "790705323",
            "telephone_number": "806-435-3606",
            "fax_number": "806-435-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3006 Garrett Dr",
            "address_purpose": "LOCATION",
            "city": "Perryton",
            "state": "TX",
            "postal_code": "790705322",
            "country_code": "US",
            "telephone_number": "806-435-6856",
            "fax_number": "806-435-4175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "MANON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G4911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132970803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryton, TX

Sources for this page

Verify at the official NPI Registry.