Individual provider Active NPI

Karen G Manning, CNP

  • Women's Health Nurse Practitioner
  • Lagrange, GA
National Provider Identifier
1104043405
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R077204 Issued in GA
Practice address
310 S Lewis St
Lagrange, GA 30240-3144
Phone
(706) 845-0500
Fax
(706) 812-9315
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R077204 GA Primary

Addresses

Primary practice location

310 S Lewis St
Lagrange, GA 30240-3144

Mailing address

310 S Lewis St
Lagrange, GA 30240-3144
Phone (706) 845-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220128001042 GA Practitioner - Nurse Practitioner 3971995747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Center for Womens Health PCGroup PAC ID 9335166164, 2 clinicians

Practice addresses (Care Compare)

310 S Lewis St
Lagrange, GA 30240-3144
Phone (706) 845-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R077204GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Center for Womens Health PC Women'S Health CurrentSince Jan 1, 2022 Accepting new patients

Locations

310 S Lewis St
Lagrange, GA 30240
Phone (706) 845-0500

Interoperability endpoints

  • Direct secure messaging: karen.manning.1@12492.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1104043405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S LEWIS ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403144",
            "telephone_number": "706-845-0500",
            "fax_number": "706-812-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S LEWIS ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403144",
            "telephone_number": "706-845-0500",
            "fax_number": "706-812-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "KAREN",
        "middle_name": "G",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "R077204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.