Edward Matthew Maner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

330 N Broad St
Forest, MS 39074-3508

Phone

(601) 469-4151

NPI assigned

Jan 23, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Medicare reassignment NPD
• Jackson HB Medical Services LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1184305856
  Medicare reassignment
• Independent Healthcare Management, Inc.

  • Rural Health Clinic/Center
  • Raleigh, MS
  • NPI 1871272724
  NPD

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1760197958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N BROAD ST",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390743508",
            "telephone_number": "601-469-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BROAD ST",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390743508",
            "telephone_number": "601-469-4151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Highpoint Dr",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391576018",
            "country_code": "US",
            "telephone_number": "706-840-3854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANER",
        "first_name": "EDWARD",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "MS",
            "license": "1020521",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Paul Lee, M.D.
• William Mark Lewis, M.D.
• LLH Labs
• Trenton D Lott, PHARM.D.
• Majestic Estates LLC.
• Jordan B Manning, DPT
• Jessica Gail Martin, RPT
• Brittany Latay McClendon Spivey, DPT
• Kaylin McCree, SLP
• Megan Elizabeth McDaniel, FNP

• Physician Assistant in Forest, MS
• Providers in Forest, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.