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Individual provider Active NPI

Misty Manuel Norman, MD

  • Diagnostic Radiology Physician
  • Baton Rouge, LA
National Provider Identifier
1699821298
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
025987 Issued in LA
Practice address
100 Womans Way
Department of Radiology, Women's Hospital
Baton Rouge, LA 70817-5100
Phone
(225) 924-8267
Fax
(225) 924-8242
NPI assigned
Jan 26, 2007
Last updated
Mar 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 239109 MA
Diagnostic Radiology Physician 2085R0202X 025987 LA Primary

Addresses

Primary practice location

100 Womans Way
Department of Radiology, Women's Hospital
Baton Rouge, LA 70817-5100

Mailing address

8230 Summa Ave Ste C
Baton Rouge, LA 70809-3465
Phone (225) 757-0552

Other identifiers 1

IdentifierTypeStateIssuer
1050202MedicaidLA

Other names 1

  • Misty Dawn Manuel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021001470 LA Practitioner - Diagnostic Radiology 9638223621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates LLCGroup PAC ID 8628041464, 83 clinicians

Practice addresses (Care Compare)

100 Womans Way
Baton Rouge, LA 70817-5100
Phone (225) 924-8267

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025987LAMDDiagnostic Radiology Physician
239109MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates LLC Diagnostic Radiology CurrentSince Mar 1, 2012 Accepting new patients
Radsouth Imaging, LLP Diagnostic Radiology Past Accepting new patients

Locations

100 Womans Way
Baton Rouge, LA 70817
Phone (225) 293-2324

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

8230 Summa Ave
Ste C
Baton Rouge, LA 70809

1100 N 18th St
Ste 100
Monroe, LA 71201
Phone (318) 361-9900

900 Johnson St
Tallulah, LA 71282
Phone (318) 395-2241

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1699821298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 SUMMA AVE STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093465",
            "telephone_number": "225-757-0552",
            "fax_number": "225-763-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOMANS WAY",
            "address_2": "DEPARTMENT OF RADIOLOGY, WOMEN'S HOSPITAL",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708175100",
            "telephone_number": "225-924-8267",
            "fax_number": "225-924-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "MISTY",
        "middle_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "239109",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "025987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1050202",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "MANUEL",
            "middle_name": "DAWN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.