Active NPI
Nicholas Kevin Mann
- Counselor
- Eureka, CA
National Provider Identifier
1104077866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1100 California St
Eureka, CA 95501-1621 - Phone
- (707) 443-8322
- NPI assigned
- Sep 30, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1100 California St
Eureka, CA 95501-1621
Mailing address
1589 Glendale Dr
McKinleyville, CA 95519-9208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redwood Community Action Agency | Past | Accepting new patients |
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.
-
- Case Manager/Care Coordinator
- Eureka, CA
- NPI 1578699260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222732800000",
"number": "1104077866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1589 GLENDALE DR",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955199208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 CALIFORNIA ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955011621",
"telephone_number": "707-443-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "NICHOLAS",
"middle_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-30",
"last_updated": "2008-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.