Individual provider Active NPI

Christopher Darin Mann, MD

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1043281256
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37310 Issued in SC
Practice address
1717A S Utica Ave
Tulsa, OK 74104-5344
Phone
(918) 748-7557
Fax
(918) 748-7514
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23589 OK
Family Medicine Physician 207Q00000X 37310 SC Primary
Emergency Medicine Physician 207P00000X 23589 OK

Addresses

Primary practice location

1717A S Utica Ave
Tulsa, OK 74104-5344

Mailing address

1515 N Harvard Ave
Ste E
Tulsa, OK 74115-4957
Phone (918) 832-6050

Other identifiers 1

IdentifierTypeStateIssuer
200045420AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922000004 SC Practitioner - Family Practice 4789632621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37310SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group Current Accepting new patients
Self Medical Group CurrentSince Dec 15, 2021 Accepting new patients
Self Medical Group CurrentSince Dec 15, 2021 Accepting new patients
Southeastern Hospitalist Services PC Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Georgetown Memorial Hospital CurrentSince May 1, 2016 Accepting new patients
Georgetown Memorial Hospital CurrentSince May 1, 2016 Accepting new patients
Grand Strand Regional Medical Center LLC Past Accepting new patients
Jane Phillips Nowata Hospital Inc Past Accepting new patients
Okmulgee Emergency PLLC Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: christopher.mann@direct.stjohnhealthsystem.com
  • Direct secure messaging: cmann73031@selfregional.direct-ci.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1043281256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N HARVARD AVE",
            "address_2": "STE E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741154957",
            "telephone_number": "918-832-6050",
            "fax_number": "918-832-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717A S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045344",
            "telephone_number": "918-748-7557",
            "fax_number": "918-748-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "CHRISTOPHER",
        "middle_name": "DARIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23589",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "37310",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "23589",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200045420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.