Connor Fawkes Manda

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2800 Freeway Blvd Ste 204
Minneapolis, MN 55430-1751

Phone

(763) 412-1996

Fax

(763) 292-5653

NPI assigned

Mar 4, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1821896085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 BROOKLYN BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "612-408-7733",
            "fax_number": "763-292-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 FREEWAY BLVD STE 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554301751",
            "telephone_number": "763-412-1996",
            "fax_number": "763-292-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDA",
        "first_name": "CONNOR",
        "middle_name": "FAWKES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William David Manahan, MD
• Michelle Ann Manalang, M.D.
• Adrienne B. Manbeck, BA
• Nicoleta Elena Manciu, M.D.
• Randy Mancuso, OPA-C
• Monica Mandell, PHD, LP
• Sydney Tennille Mandyck
• Jean Ann Mangan, PT
• Nicholas Mangan
• Rachael Lauren Mangaudis, MD

• Case Manager/Care Coordinator in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Case Manager/Care Coordinator in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.