Individual provider Active NPI

Brian C Manning, MPT

  • Physical Therapist
  • O'Fallon, MO
National Provider Identifier
1992759948
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2001009061 Issued in MO
Practice address
1096 Tom Ginnever Ave
O Fallon, MO 63366-4519
Phone
(636) 978-5255
Fax
(636) 978-5287
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2001009061 MO Primary

Addresses

Primary practice location

1096 Tom Ginnever Ave
O Fallon, MO 63366-4519

Mailing address

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504-7335
Phone (616) 356-5000

Other identifiers 1

IdentifierTypeStateIssuer
P00602663OtherMORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000014 MO Practitioner - Physical Therapist in Private Practice 7214997147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Babar Enterprises LLCGroup PAC ID 2365342318, 19 clinicians

Practice addresses (Care Compare)

1096 Tom Ginnever Ave
O Fallon, MO 63366-4519
Phone (636) 978-5255

1428 W Meyer Rd
Wentzville, MO 63385-3499
Phone (636) 887-3660

2982 Hwy K
O Fallon, MO 63368-7861
Phone (636) 978-9235

300 1St Executive Ave
Suite C
Saint Peters, MO 63376-1655
Phone (636) 939-9540

4800 Mexico Rd
Suite 104
Saint Peters, MO 63376-1666
Phone (636) 928-4199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Babar Enterprises LLC Physical Therapist CurrentSince May 1, 2004 Accepting new patients
Babar Enterprises LLC Physical Therapist Past Accepting new patients
Babar Enterprises LLC Physical Therapist Past Accepting new patients
Babar Enterprises LLC Physical Therapist Past Accepting new patients

Locations

2982 Highway K
O Fallon, MO 63368
Phone (636) 978-5255

1096 Tom Ginnever Ave
O Fallon, MO 63366
Phone (636) 978-5255

713 N New Ballas Rd
Saint Louis, MO 63141
Phone (314) 991-0480

4625 Lindell Blvd
Ste 510
Saint Louis, MO 63108
Phone (314) 367-7450

4800 Mexico Rd
Ste 104
Saint Peters, MO 63376
Phone (636) 916-4625

300 First Executive Ave
Ste C
Saint Peters, MO 63376
Phone (636) 939-9540

605 E Booneslick Rd
Ste 3
Warrenton, MO 63383
Phone (636) 456-6350

1428 W Meyer Rd
Wentzville, MO 63385
Phone (636) 327-3333

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1992759948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW",
            "address_2": "STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 TOM GINNEVER AVE",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633664519",
            "telephone_number": "636-978-5255",
            "fax_number": "636-978-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "BRIAN",
        "middle_name": "C",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2001009061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00602663",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.