Gregory Glenn Mann, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08326 Issued in TX

Practice address

1400 S Coulter St
Amarillo, TX 79106

Phone

(806) 414-9800

Fax

(806) 354-5689

NPI assigned

Mar 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregorymann@ttuhsc.allscriptsdirect.net

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.

• Texas Tech University Health Sciences Center Amarillo

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1013942150
  Medicare reassignment NPD
• Allergy Arts LLP

  • Rheumatology Physician
  • Amarillo, TX
  • NPI 1659342061
  Medicare reassignment
• Texas Tech University Health Sciences Center

  • Pharmacy
  • Lubbock, TX
  • NPI 1609810977
  NPD
• Texas Tech University Health Sciences Center Amarillo

  • Surgery Physician
  • Amarillo, TX
  • NPI 1033144175
  NPD
• Texas Tech University Health Sciences Center Amarillo

  • Pediatrics Physician
  • Amarillo, TX
  • NPI 1386675940
  NPD
• Texas Tech University Health Sciences Center Amarillo

  • Physical Therapist
  • Amarillo, TX
  • NPI 1679841134
  NPD
• Ammar Jarrous MD PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Amarillo, TX
  • NPI 1811172422
  NPD (past)

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1982978482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79106",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "GREGORY",
        "middle_name": "GLENN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-470",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2146",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356196102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27603512",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356196103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200765750A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mangold Enterprise
• Kelli Mangold, LCSW
• Kaitlyn Mangum, CTRS
• Manju Nath Mdpa
• Matthew Alan Manley, CRNA
• Leigh Monica Babiera Mantohac
• David Daniel Mara, PHARMD
• Marc Henson, M.D., P.a.
• Darla Jean Marcear, M.A.,CCC-SLP
• George J Marck, MD

• Physician Assistant in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.