JACK C MANLEY


Address: 201 N Mayfair Rd, Wauwatosa, WI 53226-4216
Phone: 4142597505

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
WI 30897900 05

Office Location

Street Address 201 N MAYFAIR RD
City WAUWATOSA
State WI
Zip Code 53226-4216

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

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)

Providers in the same taxonomy and state

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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Competitor

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City WAUWATOSA
Zip Code 53226

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Dataset Information

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.

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