Active NPI
Peter Bruce Manning, MD
- Pediatric Surgery Physician
- Saint Louis, MO
National Provider Identifier
1891747697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 2012037425
- Practice address
- 1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003 - Phone
- (314) 362-1196
- Fax
- (314) 747-3977
- NPI assigned
- May 17, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2012037425 | MO | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 2012037425 | MO | |
| Pediatric Surgery Physician | 2086S0120X | 2012037425 | MO | Primary |
Addresses
Primary practice location
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Mailing address
660 S Euclid Ave
C B 8234
Saint Louis, MO 63110-1010
Phone (314) 362-1196
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891747697 | Medicaid | MO | |
| ENROLLED | Medicaid | IL |
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 |
|---|---|---|---|
| 2012037425 | MO | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1891747697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "C B 8234",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-1196",
"fax_number": "314-747-3977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BARNES JEWISH HOSPITAL PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101003",
"telephone_number": "314-362-1196",
"fax_number": "314-747-3977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "PETER",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2012037425",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MO",
"license": "2012037425",
"primary": false
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "MO",
"license": "2012037425",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891747697",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.