Individual provider Active NPI

Rebecca Anna Manning, MD

  • Retina Specialist (Ophthalmology) Physician
  • Raleigh, NC
National Provider Identifier
1457435992
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
2010-00750 Issued in NC
Practice address
4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514
Phone
(919) 782-8038
Fax
(919) 782-8189
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 2010-00750 NC Primary
Ophthalmology Physician 207W00000X 2010-00750 NC

Addresses

Primary practice location

4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514

Mailing address

4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514
Phone (919) 782-8038

Other identifiers 1

IdentifierTypeStateIssuer
5914755MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmanning@northcarolinaretina.intellechartdirect.net

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
I20100623000237 NC Practitioner - Ophthalmology 6002947827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Alabama School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Associates, PLLCGroup PAC ID 3870498876, 18 clinicians

Practice addresses (Care Compare)

4414 Lake Boone TRL
Suite 302
Raleigh, NC 27607-7514
Phone (919) 782-8038

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-00750NCMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Associates, PLLC Ophthalmology CurrentSince Mar 5, 2012 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

220 Springbrook Ave
Ste 100
Clayton, NC 27520

5107 Southpark Dr
Ste 201
Durham, NC 27713
Phone (919) 782-8038

4414 Lake Boone Trl
Ste 302
Raleigh, NC 27607
Phone (919) 782-8038

3113 Rogers Rd
Ste 200
Wake Forest, NC 27587

Organizations & group practices 2

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1457435992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 302",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "919-782-8038",
            "fax_number": "919-782-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 302",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "919-782-8038",
            "fax_number": "919-782-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "REBECCA",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NC",
            "license": "2010-00750",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2010-00750",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5914755",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmanning@northcarolinaretina.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "4414 Lake Boone Trl Ste 302",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.