Georgia Standke Mansour, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3035 Issued in TN

Practice address

3601 The Vanderbilt Clinic
Nashville, TN 37232-5100

Phone

(615) 322-3000

NPI assigned

Jan 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dekalb Medical Specialty Care Group LLC

  • Neurology Physician
  • Decatur, GA
  • NPI 1063663037
  NPD (past)

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1922420546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 W END AVE APT 3B",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052455",
            "telephone_number": "318-393-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372325100",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "GEORGIA",
        "middle_name": "STANDKE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "7081",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA3035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ying Manrique, CNIM
• Ashley Jacobs Mansfield, CRNA
• Patricia Carter Mansfield, NP
• Justin Daniel Manson
• Mateen Hamad Mansoori
• Vafa Cyrus Mansouri, D.O.
• Vartgez K Mansourian, M.D.
• Michael F. Mantinan, M.D.
• Christopher Mantle, MD
• Jillian Mantor

• Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.