Individual provider Active NPI

Thompson C Maner, MD

  • Interventional Cardiology Physician
  • Panama City, FL
National Provider Identifier
1528093168
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME0031576 Issued in FL
Practice address
625 W Baldwin Rd Ste C
Panama City, FL 32405-3359
Phone
(850) 769-0329
Fax
(844) 212-7396
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0031576 FL
Interventional Cardiology Physician 207RI0011X ME0031576 FL Primary

Addresses

Primary practice location

625 W Baldwin Rd Ste C
Panama City, FL 32405-3359

Mailing address

625 W Baldwin Rd
Ste C
Panama City, FL 32405-3359
Phone (850) 769-0329

Other identifiers 1

IdentifierTypeStateIssuer
039475100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000674 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7911000344

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0031576FLMDInterventional Cardiology Physician
31576FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1528093168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W BALDWIN RD",
            "address_2": "STE C",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053359",
            "telephone_number": "850-769-0329",
            "fax_number": "844-563-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W BALDWIN RD STE C",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053359",
            "telephone_number": "850-769-0329",
            "fax_number": "844-212-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANER",
        "first_name": "THOMPSON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0031576",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME0031576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039475100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.