Individual provider Active NPI

Laura Jean McManus, MA, RDN, CDN, CLC

  • Registered Dietitian
  • Marcellus, NY
National Provider Identifier
1881186468
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
008037 Issued in NY
Practice address
14 Flower LN
Marcellus, NY 13108-1326
Phone
(315) 380-4787
NPI assigned
May 31, 2018
Last updated
May 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 008037 NY Primary

Addresses

Primary practice location

14 Flower LN
Marcellus, NY 13108-1326

Mailing address

14 Flower LN
Marcellus, NY 13108-1326
Phone (315) 380-4787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230424001687 NY Practitioner - Registered Dietitian Or Nutrition Professional 5193180354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dietitians of Northern New York PLLCGroup PAC ID 8022497981, 3 clinicians

Practice addresses (Care Compare)

24 E Main St
Suite E
Marcellus, NY 13108-1206
Phone (315) 221-4881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Dietitians of Northern New York, PLLC. Dietitian, Registered CurrentSince Jan 7, 2023 Accepting new patients

Locations

24 E Main St
Ste E
Marcellus, NY 13108
Phone (315) 221-4881

415 Sherman St
Watertown, NY 13601
Phone (315) 221-4881

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.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1881186468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FLOWER LN",
            "city": "MARCELLUS",
            "state": "NY",
            "postal_code": "131081326",
            "telephone_number": "315-380-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FLOWER LN",
            "city": "MARCELLUS",
            "state": "NY",
            "postal_code": "131081326",
            "telephone_number": "315-380-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "MA, RDN, CDN, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "008037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marcellus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.