Individual provider Active NPI

John William Foster Mann, MD

  • Surgery Physician
  • Winston-Salem, NC
National Provider Identifier
1306806252
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9500401 Issued in NC
Practice address
2915 Lyndhurst Ave
Winston-Salem, NC 27103-4005
Phone
(336) 765-5221
Fax
(704) 765-0430
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9500401 NC Primary

Addresses

Primary practice location

2915 Lyndhurst Ave
Winston-Salem, NC 27103-4005

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 765-5221

Other identifiers 3

IdentifierTypeStateIssuer
8911256MedicaidNC
891125GMedicaidNC
9500401OtherNCNC LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmann19910@direct.novanthealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000772 NC Practitioner - General Surgery 1951336239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
NMG Southpark Services, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 1, 2009 Accepting new patients

Locations

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

7126 Village Medical Cir
Clemmons, NC 27012
Phone (336) 448-2427

1710 Kernersville Medical Pkwy
Ste 202
Kernersville, NC 27284
Phone (336) 564-4873

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

760 Highland Oaks Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 277-4380

2915 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 760-0558

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Organizations & group practices 4

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306806252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LYNDHURST AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034005",
            "telephone_number": "336-765-5221",
            "fax_number": "704-765-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JOHN",
        "middle_name": "WILLIAM FOSTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "9500401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911256",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891125G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "9500401",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmann19910@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2915 Lyndhurst Ave",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

Verify at the official NPI Registry.