Individual provider Active NPI

Alexandra Dobbins Maner, PA-C

  • Physician Assistant
  • Hartselle, AL
National Provider Identifier
1679207203
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2105 Issued in AL
Practice address
615 Mynatt St SW
Hartselle, AL 35640-2877
Phone
(256) 773-2979
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2105 AL Primary

Addresses

Primary practice location

615 Mynatt St SW
Hartselle, AL 35640-2877

Mailing address

110 Sims Rd SW
Hartselle, AL 35640-7361
Phone (256) 654-2299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230621000670 AL Practitioner - Physician Assistant 6901264118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartselle Family MedicineGroup PAC ID 5395765762, 5 clinicians

Practice addresses (Care Compare)

615 Mynatt St SW
Suite E
Hartselle, AL 35640-2878
Phone (256) 773-2979

Hospital & facility affiliations

  • Decatur Morgan Homecare Home health agency, Decatur, AL, CCN 017027
  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2105ALMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Primary Care LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12216/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1679207203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SIMS RD SW",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356407361",
            "telephone_number": "256-654-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MYNATT ST SW",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402877",
            "telephone_number": "256-773-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANER",
        "first_name": "ALEXANDRA",
        "middle_name": "DOBBINS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "2105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartselle, AL

Sources for this page

Verify at the official NPI Registry.