Individual provider Active NPI

Craig Alan McManama, DPM

  • Podiatrist
  • West Valley City, UT
National Provider Identifier
1659430254
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
781028940501 Issued in UT
Practice address
3540 S 4000 W Ste 480
West Valley City, UT 84120-3285
Phone
(801) 966-3556
Fax
(801) 966-9839
NPI assigned
Dec 8, 2006
Last updated
Jun 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 781028940501 UT Primary

Addresses

Primary practice location

3540 S 4000 W Ste 480
West Valley City, UT 84120-3285

Mailing address

3540 S 4000 W Ste 480
West Valley City, UT 84120-3285
Phone (801) 966-3556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20100728000180 UT Practitioner - Podiatry 9234218991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3465 S Pioneer Pkwy
Suite 3
West Valley, UT 84120-2078
Phone (801) 966-3556

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue103
Removal of nail tissue1967
Removal or shaving of skin growth1193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
781028940501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Foot & Ankle Center Podiatrist CurrentSince Jul 12, 1978 Accepting new patients
West Valley Foot & Ankle Center Podiatrist Current Accepting new patients

Locations

3465 S Pioneer Pkwy
Ste 3
West Valley City, UT 84120
Phone (801) 966-3556

3540 S 4000 W
Ste 480
West Valley City, UT 84120
Phone (801) 966-3556

Organizations & group practices 2

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 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1659430254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 S 4000 W STE 480",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841203285",
            "telephone_number": "801-966-3556",
            "fax_number": "801-966-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 S 4000 W STE 480",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841203285",
            "telephone_number": "801-966-3556",
            "fax_number": "801-966-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANAMA",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "781028940501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.