Peter J Mannen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

VA0110006420 Issued in VA

Practice address

320 Hospital Dr
Martinsville, VA 24112-1900

Phone

(276) 666-7200

NPI assigned

Aug 27, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, VA, NC3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmannen801580@direct.unc.nchie.net

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.

• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  VA

  Medicare reassignment
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  VA

  Medicare reassignment
• NC Emergency Physician Services, PLLC

  • Emergency Medicine Physician
  • Eden, NC
  • NPI 1518374800

  NC

  Medicare reassignment
• St Claire Medical Center, Inc.,

  • General Acute Care Hospital
  • Morehead, KY
  • NPI 1821168535

  KY

  Medicare reassignment
• St Claire Medical Center Inc.

  • Emergency Medicine Physician
  • Morehead, KY
  • NPI 1427188077

  Emergency Medicine

  NPD
• St Claire Medical Center, Inc

  • Rural Health Clinic/Center
  • Morehead, KY
  • NPI 1477236487
  NPD

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1326529314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HOSPITAL DR",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121900",
            "telephone_number": "276-666-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 HOSPITAL DR",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121900",
            "telephone_number": "276-666-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403511179",
            "country_code": "US",
            "telephone_number": "606-783-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNEN",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "TC730",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2413",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12280",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "VA0110006420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbie Sue Maiorano, M.S. CCC-SLP
• Emily Mallinak, DDS
• Laura R Mallinak
• Raymond Frank Mallinak, DDS
• Benjamin Lowell Mann, PA
• Mark a. Crabtree DDS, LTD.
• Mark T Mahoney DO PC
• Mark Thomas Mahoney, D.O., P.C.
• Celeisha Martin, FNP-C
• Jennifer L Martin

• Physician Assistant in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.