Individual provider Active NPI

Jonathan Douglas Manley, FNP-C

  • Family Nurse Practitioner
  • Davenport, IA
National Provider Identifier
1730953761
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A190443 Issued in IA
Practice address
1520 W 53Rd St
Davenport, IA 52806-2459
Phone
(563) 421-3840
NPI assigned
Nov 9, 2023
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A190443 IA Primary

Addresses

Primary practice location

1520 W 53Rd St
Davenport, IA 52806-2459

Mailing address

1520 W 53Rd St
Davenport, IA 52806-2459
Phone (563) 421-3840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240805002046 IL Practitioner - Nurse Practitioner 7618414913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caring Family S. C.Group PAC ID 0648379503, 6 clinicians

Practice addresses (Care Compare)

781 S McHenry Ave
Crystal Lake, IL 60014-7444
Phone (815) 459-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.028686ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Family S. C. CurrentSince May 11, 2024 Accepting new patients

Locations

781 S McHenry Ave
Crystal Lake, IL 60014
Phone (815) 459-2200

781 S McHenry Ave
Ste B
Crystal Lake, IL 60014
Phone (815) 459-2200

Organizations & group practices 1

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 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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1730953761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 W 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528062459",
            "telephone_number": "563-421-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528062459",
            "telephone_number": "563-421-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "JONATHAN",
        "middle_name": "DOUGLAS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A190443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.