JACK C MANLEY (NPI# 1851351274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851351274 |
Entity Type | Individual |
Full Name | JACK C MANLEY |
Other Name | JOHN C MANLEY |
Credential | MD |
Practice Address |
201 N Mayfair Rd Wauwatosa WI 53226-4216 |
Practice Telephone | 4142597505 |
Practice Fax Number | 4142597583 |
Mailing Telephone | 4142597505 |
Mailing Fax Number | 4142597583 |
Enumeration Date | 2006-03-28 |
Last Update Date | 2015-03-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
13968 | WI | Allopathic & Osteopathic Physicians |
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
13968 | WI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 30897900 | 05 |
Street Address |
201 N MAYFAIR RD |
City | WAUWATOSA |
State | WI |
Zip Code | 53226-4216 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710989090 | Anthony A Rieder | Otolaryngology | 201 N Mayfair Rd, Suite #515, Wauwatosa, WI 53226-4216 | 2005-06-01 |
1699374066 | Cassandra Leightner | Pharmacist | 201 N Mayfair Rd, Infusion Pharmacy - 1st Floor, Wauwatosa, WI 53226 | 2020-10-18 |
1518423995 | Ascension Se Wisconsin Hospital, Inc | Clinic/Center | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2019-02-11 |
1952872376 | Amanda Janczak | Physician Assistant | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-12-11 |
1780160929 | Chad Knutson | Health Educator | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-07-11 |
1518456938 | Elizabeth Charlene Morien | Dietetic Technician, Registered | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-05-02 |
1912422692 | Kayla Jankins | Physician Assistant | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2017-08-03 |
1093248213 | Elizabeth Arnold | Dietitian, Registered | 201 N Mayfair Rd, 2nd Fl, Wauwatosa, WI 53226-4216 | 2017-04-05 |
1033651062 | Alison Ward | Nurse Practitioner | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2016-11-08 |
1619427168 | Kathleen Ann Sinclair | Nurse Practitioner | 201 N Mayfair Rd, Suite 310, Wauwatosa, WI 53226-4216 | 2016-10-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
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Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740788025 | Cardiac Cin of Milwaukee LLC | Internal Medicine | 310 E Buffalo St Ste 201, Milwaukee, WI 53202-5808 | 2018-01-31 |
1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
1669765681 | Nolan P Machernis | Internal Medicine | 2801 W Kinnickinnic River Pkwy Ste 474, Milwaukee, WI 53215-3693 | 2011-05-24 |
1437123049 | Harinder Singh Gill | Internal Medicine | 1111 Delafield Street, Suite 215, Waukesha, WI 53188-3403 | 2006-02-13 |
1912998576 | Thomas G Fenske | Internal Medicine | 2801 W. Kinnickinnic River Pkwy., Suite 925, Milwaukee, WI 53215 | 2005-11-02 |
1437660487 | Dr Ayhan Zia Sc | Internal Medicine | 2741 W Layton Ave, Milwaukee, WI 53221-2600 | 2017-10-17 |
1861734014 | Sean Michael Sliman | Internal Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2013-03-25 |
1730436817 | Muhammad Shahreyar | Internal Medicine | 3801 Spring St, Mount Pleasant, WI 53405 | 2012-08-08 |
1811216229 | Iyad Azzam | Internal Medicine | 36500 Aurora Dr, Summit, WI 53066 | 2010-05-25 |
1306161500 | Gaurav Tyagi | Internal Medicine | 600 Highland Ave, Madison, WI 53792-0001 | 2010-03-30 |
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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.