Individual provider Active NPI

Mandi Lyn Lahman, NP

  • Family Nurse Practitioner
  • Millsboro, DE
National Provider Identifier
1629461009
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000839 Issued in DE
Practice address
30265 Commerce Dr Unit 206
Millsboro, DE 19966
Phone
(302) 732-8400
NPI assigned
Mar 10, 2015
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R182872 MD
Family Nurse Practitioner 363LF0000X LG-0000839 DE Primary

Addresses

Primary practice location

30265 Commerce Dr Unit 206
Millsboro, DE 19966

Mailing address

100 E Carroll St
Salisbury, MD 21801-5422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150626000705 DE Practitioner - Nurse Practitioner 3476865866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

30265 Commerce Dr
Unit 206
Millsboro, DE 19966-3595
Phone (302) 732-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R182872MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

30668 Sussex Hwy
Laurel, DE 19956
Phone (302) 251-8870

30265 Commerce Dr
Unit 206
Millsboro, DE 19966
Phone (302) 732-8400

11101 Cathage Rd
Unit 102
Berlin, MD 21811
Phone (410) 912-6104

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

145 E Carroll St
Ste A
Salisbury, MD 21801

1639 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 543-7475

400 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 543-2255

428 W Market St
Snow Hill, MD 21863
Phone (410) 632-0892

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1629461009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30265 COMMERCE DR UNIT 206",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "19966",
            "telephone_number": "302-732-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHMAN",
        "first_name": "MANDI",
        "middle_name": "LYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R182872",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millsboro, DE

Sources for this page

Verify at the official NPI Registry.