Active NPI
Alexis Hunt Manchio, MD
- Emergency Medicine Physician
- Jackson, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 4301088049
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 788-4811
- NPI assigned
- Mar 23, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301088049 | MI | |
| Emergency Medicine Physician | 207P00000X | 4301088049 | MI | Primary |
| Emergency Medicine Physician | 207P00000X | 54506 | MN |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
PO Box 100
Royal Oak, MI 48068-0100
Phone (248) 849-3137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Maryland School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000
Hospital & facility affiliations
- Kaiser Foundation Hospital Westside
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Emergency Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Emergency Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Independent Emergency Physicians, P.C. | Past | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
500 NE Multnomah St
Fl 11
Portland, OR 97232
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Organizations & group practices 4
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Emergency Medicine, WA
-
- General Practice Physician
- Portland, OR
- NPI 1306192455
Emergency Medicine
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1780791343
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hillsboro, OR
- NPI 1891048807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1801913090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480680100",
"telephone_number": "248-849-3137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-788-4811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHIO",
"first_name": "ALEXIS",
"middle_name": "HUNT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301088049",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301088049",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "54506",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.