MR. KEVIN P MANCHENTON (NPI# 1902835606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902835606 |
| Entity Type | Individual |
| Full Name | MR. KEVIN P MANCHENTON |
| Credential | PA-C |
| Practice Address |
1601 W Saint Marys Rd Tucson AZ 85745-2623 |
| Mailing Address |
Po Box 12730 Tucson AZ 85732-2730 |
| Practice Telephone | 5208724901 |
| Practice Fax Number | 5209013642 |
| Mailing Telephone | 5206478850 |
| Mailing Fax Number | 5206478851 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2349 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1601 W SAINT MARYS RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85745-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699775528 | David A Boswell | Emergency Medicine | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2005-07-21 |
| 1285113654 | Marissa Kryger | Speech-Language Pathologist | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2018-08-07 |
| 1114438926 | Tamra L Mullen | Speech-Language Pathologist | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2017-10-19 |
| 1881117703 | Marybeth Theano Serdenes | Occupational Therapist | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2017-07-23 |
| 1669907713 | May Grace Kushner | Nurse Practitioner | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2017-04-26 |
| 1588198006 | Charles Elliott | Emergency Medicine | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2017-04-12 |
| 1093259640 | Robert Theodore Galey | Nurse Practitioner | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2016-12-15 |
| 1962944702 | Sound Physicians Intensivists of Arizona, Inc | Family Medicine | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2016-11-10 |
| 1699146324 | Lydia Esabia Fernandez | Registered Nurse | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2015-10-07 |
| 1720454341 | Smsj Tucson Holdings LLC | Psychiatric Unit | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629540679 | El Rio Santa Cruz Neighborhood Health Center Inc | Pharmacy | 839 W Congress, Tucson, AZ 85745 | 2018-12-31 |
| 1194230672 | Pascua Yaqui Tribe | Community/Behavioral Health | 1701 W. St. Mary's Road, Suite 120, Tucson, AZ 85745 | 2017-12-06 |
| 1891207106 | Intermountain Health Center, Inc. | Community/Behavioral Health | 1100 W. Fresno Street, Tucson, AZ 85745 | 2017-10-26 |
| 1497270664 | Skin Concierge, LLC. | Dermatology | 1310 W. St. Mary's Road, 2nd Floor, Suite A, Tucson, AZ 85745 | 2017-08-09 |
| 1801334941 | Katie Flores | Physical Therapist | 1604 W St Mary's Rd, Tucson, AZ 85745 | 2017-02-09 |
| 1558717348 | Jeongfill Yun | Student in an Organized Health Care Education/Training Program | 8290 W Congress St., Tucson, AZ 85745 | 2016-05-11 |
| 1417317082 | Nebsource LLC | Durable Medical Equipment & Medical Supplies | 4890 W Camino De La Amapola, Tucson, AZ 85745 | 2016-02-25 |
| 1548661358 | Melinda Godoy | Pharmacist | 879 W Congress, Tucson, AZ 85745 | 2014-09-11 |
| 1811333925 | Asdb | Clinic/Center | 1200 West Speedway, Tucson, AZ 85745 | 2013-05-15 |
| 1669722385 | David L. Lewis | Counselor | 1779 W. St. Mary's Rd, Tucson, AZ 85745 | 2012-09-11 |
| Find all providers in zip 85745 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1013499599 | Jeremy Robert Thomas | Physician Assistant | 5230 E Farness Dr Ste 100, Tucson, AZ 85712-2141 | 2018-08-31 |
| 1679859920 | Jamie Wystrach | Physician Assistant | 6127 N La Cholla Blvd Ste 101, Tucson, AZ 85741-3744 | 2011-11-01 |
| 1427290667 | William E Jackson | Physician Assistant | 9261 E Northview Ct, Tucson, AZ 85749-9792 | 2009-04-02 |
| 1366692238 | Judith Kaye Jones | Physician Assistant | 501 N Park Ave, 110, Tucson, AZ 85719-5034 | 2008-09-26 |
| 1316146681 | Britni Reann Mcbryde | Physician Assistant | 2260 W. Orange Grove Rd, Tucson, AZ 85741 | 2007-07-16 |
| 1275614786 | Amy Vinik | Physician Assistant | 1601 W St. Mary's Road, Tucson, AZ 85745 | 2006-10-18 |
| 1689611956 | Cushing Street Family Practice PC | Physician Assistant | 58 W Cushing St, Tucson, AZ 85701-2218 | 2006-06-02 |
| 1639132301 | Justin Thomas Decker | Physician Assistant | 501 N Park Ave Ste 120, Tucson, AZ 85719-5034 | 2006-04-11 |
| 1477520484 | Carlos Martin Aguilar | Physician Assistant | 1460 W Valencia Rd Ste 141, Tucson, AZ 85746-6001 | 2006-03-08 |
| Find all providers in TUCSON | ||||
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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.