Individual provider Active NPI

Misty Manuel

  • Primary Care Nurse Practitioner
  • Troy, OH
National Provider Identifier
1811536378
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.026127 Issued in OH
Practice address
998 S Dorset Rd Ste 301
Troy, OH 45373-4748
Phone
(937) 339-9865
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.026127 OH Primary

Addresses

Primary practice location

998 S Dorset Rd Ste 301
Troy, OH 45373-4748

Mailing address

998 S Dorset Rd Ste 301
Troy, OH 45373-4748
Phone (937) 339-9865

Other identifiers 1

IdentifierTypeStateIssuer
APRN.CNP.026127OtherOHAPRN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmanuel@premierhealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200218003128 OH Practitioner - Nurse Practitioner 5991132607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upper Valley Professional CorporationGroup PAC ID 5597658138, 83 clinicians

Practice addresses (Care Compare)

998 S Dorset Rd
Suite 301
Troy, OH 45373-4748
Phone (937) 339-9865

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

Merit-based Incentive Payment System (MIPS)

Final score
88.89 of 100Reported as group
Quality
83.16
Promoting interoperability
100
Improvement activities
40
Cost
79.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Valley Professional Corporation CurrentSince Feb 3, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3170 Kettering Blvd
Fl Third
Moraine, OH 45439

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

998 S Dorset Rd
Ste 301
Troy, OH 45373
Phone (937) 339-5441

Organizations & group practices 2

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.

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1811536378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 S DORSET RD STE 301",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453734748",
            "telephone_number": "937-339-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 S DORSET RD STE 301",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453734748",
            "telephone_number": "937-339-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "MISTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.026127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "APRN.CNP.026127",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmanuel@premierhealth.com",
            "affiliation": "N",
            "endpointDescription": "secured email",
            "address_1": "998 S Dorset Rd Ste 301",
            "city": "Troy",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453734748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

Verify at the official NPI Registry.