John A Manfredi, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

16101 Issued in GA

Practice address

308 Deep South Farm Rd
Suite 200
Blairsville, GA 30512-2218

Phone

(706) 835-2235

Fax

(706) 835-1706

NPI assigned

Aug 15, 2005

Last updated

Apr 9, 2015By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northside Hospital, Inc.

  dba Atlanta Cancer Care

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1861416562
  NPD (past)
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  NPD (past)
• Physicians' Immediate Med

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1912948217
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1629070131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "678-288-9555",
            "fax_number": "678-288-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 DEEP SOUTH FARM RD",
            "address_2": "SUITE 200",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122218",
            "telephone_number": "706-835-2235",
            "fax_number": "706-835-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFREDI",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "16101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011382K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011382M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Charles Lovelace, HADS,HIS
• Jake Paul Lundquist, FNP-C
• Emma Gene Lyles
• Ronald A Macbeth Jr., M.D.
• Ronald Ray Mallory, CRNA
• Mark Baker, Inc. (Baker Chiropractic Clinic)
• Mark J. Greenbaum, D.P.M., P.C. (Northpointe Foot and Ankle Center)
• Kimberly Kennedy Martin
• Seth Martin
• Mary Beth Wiles, M.D., PC (Internal Medicine Associates)

• Hematology & Oncology Physician in Blairsville, GA
• Providers in Blairsville, GA by specialty
• Hematology & Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.