Individual provider Active NPI

Emily L. Manns, PA-C

  • Physician Assistant
  • Jackson, TN
National Provider Identifier
1861949760
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 3046 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 512-1264
Fax
(731) 352-4459
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 3046 TN Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other identifiers 2

IdentifierTypeStateIssuer
3380640OtherTNGROUP MEDICARE
3380640OtherTNGROUP MEDICAID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20160926001685 TN Practitioner - Physician Assistant 7517254113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Healthcare Hospitalists IncGroup PAC ID 1951735521, 98 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-4923

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 3046TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Medical Center Physician Assistant Past Accepting new patients
McKenzie Medical Center Past Accepting new patients
McKenzie Medical Center, PC Physician Assistant Past Accepting new patients

Organizations & group practices 5

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 1

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1861949760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "SUITE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-512-1264",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNS",
        "first_name": "EMILY",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA 3046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "3380640",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "3380640",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.