Active NPI
Oksana Kovalyova Manning
- Nurse Practitioner
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5020595
- Practice address
- 105 Hanes Square Cir
Winston Salem, NC 27103-5514 - Phone
- (336) 441-5569
- Fax
- (336) 771-1907
- NPI assigned
- Aug 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5020595 | NC | Primary |
| Nurse Practitioner | 363L00000X | F01241462 | NC |
Addresses
Primary practice location
105 Hanes Square Cir
Winston Salem, NC 27103-5514
Mailing address
PO Box 601843
Charlotte, NC 28260-1843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
105 Hanes Square Cir
Winston Salem, NC 27103-5514
Phone (336) 441-5569
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F01241462 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Medicorp Enterprises, LLC | Current | Accepting new patients | |
| Carolina Medicorp Enterprises, LLC | Current | Accepting new patients | |
| Carolina Medicorp Enterprises Inc | Past | Accepting new patients |
Locations
9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510
600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040
105 Hanes Square Cir
Winston Salem, NC 27103
Phone (336) 441-5569
Interoperability endpoints
- omanning142655@direct.novanthealth.org
Organizations & group practices 3
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.
-
- Urgent Care Clinic/Center
- Charlotte, NC
- NPI 1760950646
-
- Urgent Care Clinic/Center
- Asheville, NC
- NPI 1235014796
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1417497504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1124859129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601843",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 HANES SQUARE CIR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035514",
"telephone_number": "336-441-5569",
"fax_number": "336-771-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "OKSANA",
"middle_name": "KOVALYOVA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-12",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5020595",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "F01241462",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.