Active NPI
Tra'Jyseia Manns, MA
- Developmental Therapist
- Jacksonville, FL
National Provider Identifier
1720811862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 1177175
- Practice address
- 2787 Ivy Post Dr
Jacksonville, FL 32226-1290 - Phone
- (704) 449-0667
- NPI assigned
- Aug 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 1177175 | NC | Primary |
Addresses
Primary practice location
2787 Ivy Post Dr
Jacksonville, FL 32226-1290
Mailing address
2787 Ivy Post Dr
Jacksonville, FL 32226-1290
Phone (704) 449-0667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1177175 | NC | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1720811862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2787 IVY POST DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322261290",
"telephone_number": "704-449-0667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2787 IVY POST DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322261290",
"telephone_number": "704-449-0667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNS",
"first_name": "TRA'JYSEIA",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-23",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NC",
"license": "1177175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.