NPIMap

Individual provider Active NPI

Anthony Tyler Manning, M.D.

  • Surgery Physician
  • Conway, AR
National Provider Identifier
1811333206
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
BP10047355 Issued in TX
Practice address
525 Western Ave
Ste 203
Conway, AR 72034-4980
Phone
(501) 327-4828
Fax
(501) 327-6899
NPI assigned
May 13, 2013
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X BP10047355 TX Primary
Surgery Physician 208600000X E-10862 AR

Addresses

Primary practice location

525 Western Ave
Ste 203
Conway, AR 72034-4980

Mailing address

525 Western Ave
Ste 203
Conway, AR 72034-4980
Phone (501) 327-4828

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-2366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180628002114 AR Practitioner - General Surgery 9931481017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Arkansas College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 Western Ave
Suite 203
Conway, AR 72034-4980
Phone (501) 327-4828

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy16
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Pacemaker insertion or repair1-10
Upper gastrointestinal (GI) endoscopy for acid reflux14
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10047355TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc CurrentSince Feb 3, 2019 Accepting new patients
Conway Regional Medical Center Inc Surgery CurrentSince Feb 3, 2019 Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients

Locations

525 Western Ave
Ste 203
Conway, AR 72034
Phone (501) 327-4828

Organizations & group practices 3

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 7

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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1811333206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE",
            "address_2": "STE 203",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344980",
            "telephone_number": "501-327-4828",
            "fax_number": "501-327-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE",
            "address_2": "STE 203",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344980",
            "telephone_number": "501-327-4828",
            "fax_number": "501-327-6899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2366",
            "fax_number": "254-724-7827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNING",
        "first_name": "ANTHONY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10047355",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-10862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.