Kurtis A Manley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4423 Issued in AZ

Practice address

2226 Hualapai Mountain Rd
Kingman, AZ 86401-8374

Phone

(928) 681-8530

Fax

(928) 681-8531

NPI assigned

Oct 5, 2005

Sex

Male

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

Enrolled in AZ

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

State licenses

Practice roles

Locations

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.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Medicare reassignment NPD (past)
• Raghav LLC

  • Multi-Specialty Clinic/Center
  • Surprise, AZ
  • NPI 1598125791
  Medicare reassignment
• Kingman Healthcare, Inc

  • Urgent Care Clinic/Center
  • Kingman, AZ
  • NPI 1760703805
  NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Physician Assistant

  NPD (past)
• River City Medical Group, Inc.

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1083722516
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1992792758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 HUALAPAI MOUNTAIN RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864018374",
            "telephone_number": "928-681-8530",
            "fax_number": "928-681-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 HUALAPAI MOUNTAIN RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864018374",
            "telephone_number": "928-681-8530",
            "fax_number": "928-681-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "KURTIS",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 16493",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila R Mane, MD
• Mangelsdorf Family Dentistry
• Jesse Isaac Mangelsdorf, D.D.S.
• Luke Michael Mangelsdorf, DMD
• Timothy William Mangelsdorf
• Christine E Manross, MS SLP
• Gina Manross, MS, LAC-21925
• Mantro Mobile Imaging, LLC
• Marigold Sunset CHS
• Marlie E Lucas

• Medical Physician Assistant in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.