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GARY W MANLY CRNA
NPI 1023013000
Nurse Anesthetist, Certified Registered in Pine Bluff, AR

Active since June 16, 2005
1801 W 40TH AVE, STE 2B, PINE BLUFF, AR 71603(870) 535-7457(870) 535-2522 Get Directions Write a Review

NPPES record last updated: June 24, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gary W Manly Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY W MANLY CRNA (NPI 1023013000) is an individual nurse anesthetist, certified registered in Pine Bluff, Arkansas, licensed in Arkansas (CRNA416) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1023013000
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameGARY W MANLYCredential: CRNA
Location Address1801 W 40TH AVE, STE 2BPine Bluff, AR 71603-6957
Mailing AddressPo Box 1272Pine Bluff, AR 71613-1272 · (870) 535-7457 · Fax (870) 535-2522
Phone(870) 535-7457
Fax(870) 535-2522
Sole ProprietorNo
Enumeration DateJune 16, 2005
Last NPPES UpdateJune 24, 2008
✔ NPI 1023013000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in AR · CRNA416
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
1801 W 40TH AVE, Pine Bluff, AR 71603
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Other Identifiers 5

OtherAR6003789Tricare/humana
Other430014160Rrmcr/pgba
Medicare PIN59625AR
Medicaid125082701AR
Other59625AR · Bcbs

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary W Manly Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Gary Manly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Howard Memorial Hospital
108 mi
Nurse Anesthetist, Certified Registered
130 MEDICAL CIRCLE
Nashville, AR 71852
  • Reassigned Medicare billing, Arkansas enrollment
  • 4 clinicians in this Medicare group
NPI 1609920370 (870) 845-8024

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFERSON ANESTHESIOLOGY ASSOCIATES
Anesthesiology
1801 W 40TH AVE, SUITE 2B
PINE BLUFF, AR 71603
Jefferson County (870) 535-7457
JOHN E HARRIS MD PA
Family Medicine
1801 W 40TH AVE, SUITE 5C
PINE BLUFF, AR 71603
Jefferson County (870) 534-0202
FAWAD H WALAJAHI M.D.
Anesthesiology
1801 W 40TH AVE, STE 2B
PINE BLUFF, AR 71603
Jefferson County (870) 535-7457
JONATHAN M LOETSCHER CRNA
Nurse Anesthetist, Certified Registered
1801 W 40TH AVE, SUITE 2B
PINE BLUFF, AR 71603
Jefferson County (870) 535-7457
PINE BLUFF RADIOLOGISTS, LTD
Specialist
1801 W 40TH AVE, SUITE 2C
PINE BLUFF, AR 71603
Jefferson County (870) 534-8651
DR. JAMES L WORKMAN M.D.
Radiology (Diagnostic Radiology)
1801 W 40TH AVE, SUITE 2C
PINE BLUFF, AR 71603
Jefferson County (870) 534-8651
JACQUELYN S. FRIGON, M.D., P.A.
Physical Medicine & Rehabilitation
1801 W 40TH AVE, SUITE 5B
PINE BLUFF, AR 71603
Jefferson County (870) 535-4800
FERDINAND K SAMUEL M.D.
Anesthesiology
1801 W 40TH AVE, STE 2B
PINE BLUFF, AR 71603
Jefferson County (870) 535-7457

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Manly's NPI number?

The NPI number for Gary Manly is 1023013000. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Gary Manly located?

Gary Manly practices at 1801 W 40th Ave Ste 2B, Pine Bluff, AR 71603. The listed phone number is (870) 535-7457.

What is Gary Manly's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Gary Manly enrolled in Medicare?

Yes. Gary Manly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gary Manly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Manly reassigns Medicare benefits to Howard Memorial Hospital (Nashville, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gary Manly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gary Manly was last updated on June 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.