DR. WAYNE KENNETH MANNESS (NPI# 1710936497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710936497 |
| Entity Type | Individual |
| Full Name | DR. WAYNE KENNETH MANNESS |
| Credential | MD |
| Practice Address |
1709 Jumer Dr Suite B Bloomington IL 61704-0914 |
| Practice Telephone | 3096650640 |
| Practice Fax Number | 3096650657 |
| Mailing Telephone | 3096650640 |
| Mailing Fax Number | 3096650657 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2010-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
35.091090 | OH | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
0101242387 | VA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD057715L | PA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
25MA06727700 | NJ | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
D00661190 | MD | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036-099816 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | GROUP PTAN | 212545 | 01 |
| IL | GROUP PTAN | 202926 | 01 |
| IL | 036099816 | 05 |
| Street Address |
1709 JUMER DR SUITE B |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-0914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366490658 | Joseph Porinchu Alenghat | Radiology | 1709 Jumer Dr, Suite B, Bloomington, IL 61704-0914 | 2006-05-05 |
| 1730128315 | Midwest Center for Sleep Medicine, LLC | Clinic/Center | 1709 Jumer Dr, Bloomington, IL 61704 | 2006-06-06 |
| 1881641371 | Central Illinois Neuroradiology, Ltd | Specialist | 1709 Jumer Dr, Suite B, Bloomington, IL 61704-0909 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093166274 | Medical Scanning Consultants, P.a. | Radiology | 3802 W Industrial Blvd, Suite 4, Bloomington, IN 47403-5141 | 2016-06-28 |
| 1730489790 | Alliance Telemed LLC | Radiology | 2600 S Henderson St, Suite 122, Bloomington, IN 47401-8439 | 2010-10-25 |
| 1174839716 | Donald C Buehner | Radiology | 500 S. Landmark Ave, Bloomington, IN 47402-4366 | 2010-08-20 |
| 1457682239 | Strickler Radiology LLC | Radiology | 4011 S. Monroe Med Park Blvd, Bloomington, IN 47403-8000 | 2010-01-19 |
| 1316276108 | Herbert Eugene Parks | Radiology | 9416 S Harbour Pointe Dr, Bloomington, IN 47401-8100 | 2009-12-08 |
| 1043339310 | Jonathan Andrew Staser | Radiology | 429 S Landmark Avenue, Bloomington, IN 47403-5003 | 2007-03-28 |
| 1033169024 | Peter Constantini | Radiology | 4801 W 81st St, Suite 108, Bloomington, MN 55437-1111 | 2006-05-11 |
| 1366490658 | Joseph Porinchu Alenghat | Radiology | 1709 Jumer Dr, Suite B, Bloomington, IL 61704-0914 | 2006-05-05 |
| 1558326124 | Sira Imaging Center LLC | Radiology | 500 S Landmark Ave, Bloomington, IN 47403-3239 | 2006-04-18 |
| 1558354753 | John Francis Alexander | Radiology | 429 S Landmark Ave, Bloomington, IN 47403-5003 | 2005-08-24 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on DR. WAYNE KENNETH MANNESS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.