Keith P Mankin, MD

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

200001509 Issued in NC

Practice address

4301 Lake Boone TRL
Ste 205
Raleigh, NC 27607-7507

Phone

(919) 977-0427

Fax

(919) 977-0896

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Raleigh Durham Medical Group, PA

  • Pediatric Orthopaedic Surgery Physician
  • Raleigh, NC
  • NPI 1841621281
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416614400000",
    "number": "1528061348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 LAKE BOONE TRL",
            "address_2": "STE. 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077507",
            "telephone_number": "919-977-0427",
            "fax_number": "919-977-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 LAKE BOONE TRL",
            "address_2": "STE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077507",
            "telephone_number": "919-977-0427",
            "fax_number": "919-977-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKIN",
        "first_name": "KEITH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2014-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "200001509",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NC",
            "license": "200001509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891275V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1275V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayadev Manikkam Umakanthan, MD
• Eva M Manitius, M.D.
• Vaishali Sukhani Mankad, MD
• Kassidy Lorraine Manke, MS, RDN, LDN
• Emma Gray Mankin, LCSWA
• Robert Grenfell Mankoff, PH.D.
• Alison R Mann, LCSW
• Brian Mann, MA, LPC
• Celeta Marie Mann
• Courtney H Mann, MD

• Pediatric Orthopaedic Surgery Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatric Orthopaedic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.