RICHARD LEON MANRIQUE (NPI# 1548299332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548299332 |
Entity Type | Individual |
Full Name | RICHARD LEON MANRIQUE |
Credential | MD |
Practice Address |
1816 Eagle Dr Suite 200-b Woodstock GA 30189-8272 |
Mailing Address |
Po Box 28118 Atlanta GA 30358-0118 |
Practice Telephone | 4048225605 |
Mailing Telephone | 4048225605 |
Enumeration Date | 2006-07-02 |
Last Update Date | 2009-09-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | 031286 | GA | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | 031286 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 000395216L | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124689625 | Richard J Manrique | Family Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2019-06-25 |
Street Address |
1816 EAGLE DR SUITE 200-B |
City | WOODSTOCK |
State | GA |
Zip Code | 30189-8272 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013997139 | Ross Joseph Brakeville | Physical Therapist | 1816 Eagle Dr, Building 100, Suite C, Woodstock, GA 30189-8272 | 2006-01-17 |
1306203427 | Kragor Orthodontics LLC | Dentist | 1816 Eagle Dr, Suite 100-b, Woodstock, GA 30189-8272 | 2016-01-20 |
1336420017 | Robert Riesing | Physical Therapist | 1816 Eagle Dr, Suite C, Woodstock, GA 30189-8272 | 2011-09-08 |
1346540432 | Park Pediatric Dentistry of Woodstock, LLC | Dentist | 1816 Eagle Dr, Suite 200-c, Woodstock, GA 30189-8272 | 2010-10-24 |
1750514295 | Eagle Drive Family Medicine PC | General Practice | 1816 Eagle Dr, Suite 200-b, Woodstock, GA 30189-8272 | 2009-09-01 |
1710022942 | Julius Park | Dentist | 1816 Eagle Dr, 200-c, Woodstock, GA 30189-8272 | 2007-02-21 |
1972659332 | Pt Solutions of Acworth, LLC | Physical Therapist | 1816 Eagle Dr, Building 100, Suite C, Woodstock, GA 30189-8272 | 2007-01-26 |
1538210695 | Scott Harden | Dentist | 1816 Eagle Dr, Bldg 200 Ste A, Woodstock, GA 30189-8272 | 2007-01-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
Find all providers in zip 30189 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
1679726277 | Harry Daniel Watkins Jr. | General Practice | 225 Creekstone Rdg Ste 375, Woodstock, GA 30188 | 2008-10-28 |
1629168059 | William Shevin | General Practice | 50 Applewood Dr, Woodstock, CT 06281 | 2006-10-14 |
1083919419 | Leo A. Reyes, M.d.,p.c. | General Practice | 1664 S. Eastwood Drive, Woodstock, IL 60098-4655 | 2011-01-16 |
1750514295 | Eagle Drive Family Medicine PC | General Practice | 1816 Eagle Dr, Suite 200-b, Woodstock, GA 30189-8272 | 2009-09-01 |
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1811507247 | Magnolia Medical Center LLC | General Practice | 101 Chase Ct Nw Ste B, Milledgeville, GA 31061-7188 | 2020-07-31 |
1952927279 | Total Health Solutions Medical Center | General Practice | 12220 Birmingham Hwy Ste A, Milton, GA 30004-4184 | 2020-06-23 |
1386260131 | Midnight Rose, LLC | General Practice | 6380 Bells Ferry Rd, Acworth, GA 30102-5435 | 2020-06-17 |
1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
1053946004 | Proactive Medical Center | General Practice | 3455 Peachtree Industrial Blvd Ste 910, Duluth, GA 30096-6502 | 2020-03-10 |
1285265546 | Idea Body Institute Atlanta Asc | General Practice | 371 E Paces Ferry Rd Ne Ste 450, Atlanta, GA 30305-3292 | 2020-01-27 |
1730729849 | Summit Health Primary and Urgent Care LLC | General Practice | 120 Handley Rd Bldg 400 Ste #410, Tyrone, GA 30290-3029 | 2020-01-07 |
1770121030 | New Life Medical Centers Georgia LLC | General Practice | 3550 Lenox Rd Ne Ste 2100, Atlanta, GA 30326-1810 | 2019-12-18 |
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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.