Jerry Ray Manning Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13241 Issued in FL

Practice address

1055 Piney Forest Rd
Suite a
Danville, VA 24540-4154

Phone

(434) 836-2905

NPI assigned

Mar 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1881864569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 CLYDE MORRIS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "563-884-5810",
            "fax_number": "563-884-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 PINEY FOREST RD",
            "address_2": "SUITE A",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404154",
            "telephone_number": "434-836-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "JERRY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13241",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556602",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C05545",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881864569",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Helen Malcolm, M.D.
• Malcolm John Mallery, DDS
• Tara Beth Mancl, MD
• Marsha Mann, THERAPIST
• Manning Chiropractic
• Keyarra Manns
• Julie Maples
• Mark Philip Smith DDS PC
• Susan Gregg Marquez, MS, RD, CSSD
• Casey Alexander Marsh, PA-C

• Chiropractor in Danville, VA
• Providers in Danville, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.