Active NPI
Manuel B Cuesta, M.D.
- Specialist
- Baxley, GA
National Provider Identifier
1821042888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 018286
- Practice address
- 105 E Tollison St Ste B
Baxley, GA 31513-0150 - Phone
- (912) 366-6600
- Fax
- (912) 367-7841
- NPI assigned
- May 22, 2006
- Last updated
- Sep 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 018286 | GA | Primary |
Addresses
Primary practice location
105 E Tollison St Ste B
Baxley, GA 31513-0150
Mailing address
PO Box 2070
Baxley, GA 31515-2070
Phone (912) 367-0102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000857018E | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018286 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurological Associates of the South, LLC | Specialist | Past | Accepting new patients |
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.
-
- Specialist
- Waycross, GA
- NPI 1174578553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1821042888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2070",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315152070",
"telephone_number": "912-367-0102",
"fax_number": "912-367-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 E TOLLISON ST STE B",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315130150",
"telephone_number": "912-366-6600",
"fax_number": "912-367-7841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUESTA",
"first_name": "MANUEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2020-09-02",
"certification_date": "2020-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "018286",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000857018E",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baxley, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.