JONATHAN DOUGLAS MANLEY (FNP-C) – Family Nurse Practitioner, NPI 1730953761

JONATHAN DOUGLAS MANLEY (FNP-C) is a healthcare provider. based in Crystal lake, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 209.028686 (IL). The NPI Number for JONATHAN DOUGLAS MANLEY (FNP-C) is 1730953761

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN DOUGLAS MANLEY (FNP-C)
NPI
1730953761
Phone
Not provided
Address
781 S MCHENRY AVE STE B
Enumeration Date
9 November 2023
Last Update Date
9 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8154592200
Graduation Year
2023 (3 years ago)
PAC ID
7618414913
Group Practice PAC ID
0648379503
Professional Enrollment ID
I20240805002046
Address ID
IL600147444CR781XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for JONATHAN DOUGLAS MANLEY (FNP-C)

  • 781 S MCHENRY AVE STE B

    CRYSTAL LAKE, IL 600147444

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240805002046INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648379503View full group profile
NameSpecialtyState
Family PracticeIL
Nurse PractitionerIL
Internal Medicine, Pediatric MedicineIL
Internal Medicine, Pediatric MedicineIL
Pediatric Medicine, Internal MedicineIL

Reviews

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Frequently asked questions

What identifier follows JONATHAN DOUGLAS MANLEY (FNP-C) across health systems?
The NPI 1730953761 uniquely identifies JONATHAN DOUGLAS MANLEY (FNP-C) in U.S. healthcare data.
Should I treat JONATHAN DOUGLAS MANLEY (FNP-C) as an active provider?
Patients and plans typically see JONATHAN DOUGLAS MANLEY (FNP-C) as active in the national extract.
Which specialty label fits JONATHAN DOUGLAS MANLEY (FNP-C)?
NPPES ties JONATHAN DOUGLAS MANLEY (FNP-C) to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JONATHAN DOUGLAS MANLEY (FNP-C)?
JONATHAN DOUGLAS MANLEY (FNP-C) is associated with Crystal Lake, Illinois in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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