Individual provider Active NPI

Annmarie W McManus, PA-C, PT

  • Physician Assistant
  • Paoli, PA
National Provider Identifier
1578772281
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055900 Issued in PA
Practice address
195 W Lancaster Ave
Paoli, PA 19301-1748
Phone
(484) 222-0341
Fax
(609) 357-9496
NPI assigned
May 21, 2007
Last updated
Mar 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT022714 PA
Physician Assistant 363A00000X PA929 NV
Physician Assistant 363A00000X MA055900 PA Primary

Addresses

Primary practice location

195 W Lancaster Ave
Paoli, PA 19301-1748

Mailing address

195 W Lancaster Ave
Paoli, PA 19301-1748
Phone (484) 222-0341

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PT022714PAMDPhysical Therapist
PA929NVMDPhysician Assistant
MA055900PAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1578772281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011748",
            "telephone_number": "484-222-0341",
            "fax_number": "609-357-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011748",
            "telephone_number": "484-222-0341",
            "fax_number": "609-357-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "ANNMARIE",
        "middle_name": "W",
        "credential": "PA-C, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022714",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA929",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.