Individual provider Active NPI

Jennifer L McManus, C.R.N.P

  • Family Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1689919961
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R120765 Issued in MD
Practice address
50 Post Office Rd Ste 304
Waldorf, MD 20602-3704
Phone
(301) 349-2448
Fax
(301) 349-2243
NPI assigned
Nov 28, 2012
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 R120765 MD Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 6698 MD

Addresses

Primary practice location

50 Post Office Rd Ste 304
Waldorf, MD 20602-3704

Mailing address

5140 Port Tobacco Rd
Nanjemoy, MD 20662-3317
Phone (240) 417-6424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20151001000866 MD Practitioner - Nurse Practitioner 4183856131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Plains Primary CareGroup PAC ID 0547492597, 2 clinicians

Practice addresses (Care Compare)

50 Post Office Rd
Suite 304
Waldorf, MD 20602-3704
Phone (240) 349-2448

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6698MDMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Primary Care Addiction (Substance Use Disorder) Current Accepting new patients
White Plains Primary Care Family CurrentSince Jun 24, 2015 Accepting new patients
White Plains Primary Care Past Accepting new patients
McLaren Medical Center PC Past Accepting new patients

Locations

50 Post Office Rd
Ste 304
Waldorf, MD 20602
Phone (240) 349-2448

4550 Crain Hwy
Ste 102
White Plains, MD 20695
Phone (240) 349-2448

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12136/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1689919961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 PORT TOBACCO RD",
            "city": "NANJEMOY",
            "state": "MD",
            "postal_code": "206623317",
            "telephone_number": "240-417-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 POST OFFICE RD STE 304",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023704",
            "telephone_number": "301-349-2448",
            "fax_number": "301-349-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "C.R.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R120765",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "6698",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.