Individual provider Active NPI

David Justin Manning, O.D.

  • Optometrist
  • Vilonia, AR
National Provider Identifier
1972519783
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2576 Issued in AR
Practice address
1122 Main St
Suite 12
Vilonia, AR 72173-9524
Phone
(501) 796-8040
Fax
(501) 796-3773
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2576 AR Primary

Addresses

Primary practice location

1122 Main St
Suite 12
Vilonia, AR 72173-9524

Mailing address

1122 Main St
Suite 12
Vilonia, AR 72173-9524
Phone (501) 796-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061121000429 AR Practitioner - Optometry 1557369865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1700 Club Manor Dr
Suite 102
Maumelle, AR 72113-7685
Phone (501) 851-2170

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2576ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David Manning, OD, PA Optometrist CurrentSince May 1, 2011 Accepting new patients
Shane E. Ford OD PA Optometrist Past Accepting new patients
Jacksonville Vision Development Center PA Optometrist PastSince Nov 3, 2019 Accepting new patients
Flippin-Westfall Eyecare Center PC Optometrist PastSince Jul 5, 2016 Accepting new patients

Locations

1700 Club Manor Dr
Ste 102
Maumelle, AR 72113
Phone (501) 851-2170

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972519783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 MAIN ST",
            "address_2": "SUITE 12",
            "city": "VILONIA",
            "state": "AR",
            "postal_code": "721739524",
            "telephone_number": "501-796-8040",
            "fax_number": "501-796-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 MAIN ST",
            "address_2": "SUITE 12",
            "city": "VILONIA",
            "state": "AR",
            "postal_code": "721739524",
            "telephone_number": "501-796-8040",
            "fax_number": "501-796-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "DAVID",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vilonia, AR

Sources for this page

Verify at the official NPI Registry.