NPIMap

Organization Active NPI

Easton L. Manderson, M.D., F.a.C.S., PC

Doing business as Manderson Orthopaedic Clinic and Joint Pain Center

  • Orthopaedic Surgery Physician
  • Washington, DC
National Provider Identifier
1710919501
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
EASTON L. MANDERSON, M.D., F.A.C.S., PC
Doing business as
Manderson Orthopaedic Clinic and Joint Pain Center
Practice address
1140 Varnum St NE Ste 108
Washington, DC 20017-2152
Phone
(202) 526-5300
Fax
(202) 526-6013
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Dr. Easton L. Manderson, M.D.NPI 1972532760
Title
Owner
Phone
(202) 526-5300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1140 Varnum St NE Ste 108
Washington, DC 20017-2152

Mailing address

1140 Varnum St NE Ste 108
Washington, DC 20017-2152
Phone (202) 526-5300

Other identifiers 6

IdentifierTypeStateIssuer
F921OtherDCCAREFIRST
147572700OtherDCDEPT OF LABOR
60184300OtherDCAMERIHEALTH DC MEDICAID
DE6844OtherGARAILROAD MEDICARE
021189900MedicaidDC
4053124OtherAETNA

Other names 1

  • Manderson Orthopaedic Clinic and Joint Pain Center Doing business as

National Provider Directory

National Provider Directory

Locations

1140 Varnum St NE
Ste 108
Washington, DC 20017
Phone (202) 526-5300

1140 Varnum St NE
Ste 207
Washington, DC 20017
Phone (202) 526-5300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1710919501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 VARNUM ST NE STE 108",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172152",
            "telephone_number": "202-526-5300",
            "fax_number": "202-526-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 VARNUM ST NE STE 108",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172152",
            "telephone_number": "202-526-5300",
            "fax_number": "202-526-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTON L. MANDERSON, M.D., F.A.C.S., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "MANDERSON",
        "authorized_official_first_name": "EASTON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-526-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "F921",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "147572700",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH DC MEDICAID",
            "identifier": "60184300",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE6844",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021189900",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4053124",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manderson Orthopaedic Clinic and Joint Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.