Nicole Manlin, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

137025 Issued in MO

Practice address

14855 N Outer 40
Chesterfield, MO 63017-2026

Phone

(636) 532-0150

NPI assigned

May 23, 2006

Last updated

Jul 17, 2017By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Specialized Wound Management LLC

  dba Specialized Wound Management

  • Adult Health Nurse Practitioner
  • Chesterfield, MO
  • NPI 1962430157

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1649225103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14805 N OUTER 40 RD",
            "address_2": "SUITE 320",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630176060",
            "telephone_number": "888-811-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14855 N OUTER 40",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172026",
            "telephone_number": "636-532-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLIN",
        "first_name": "NICOLE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "137025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427588108",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Sue Mandlman, SLP
• Jose L Manes, MD
• Grant Mangan
• Manish Suthar MD PC
• Keith Mankowitz, MD
• Katrina Joan Mann, MS, RD, CDCES
• Suvidha Manne, MD
• Lisa Marie Mantia, FNP, BC
• Manual Therapy Specialists, LLC
• Tanisha Marangattu Abraham

• Adult Health Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.