Individual provider Active NPI

Caitlin Mary Manahan, NP-C

  • Women's Health Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1790506814
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0024191636 Issued in VA
Practice address
102 Highland Ave SE Ste 303
Roanoke, VA 24013-2253
Phone
(540) 985-9715
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0024191636 VA Primary

Addresses

Primary practice location

102 Highland Ave SE Ste 303
Roanoke, VA 24013-2253

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241212004487 VA Practitioner - Nurse Practitioner 4688100605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

102 Highland Ave SE
Roanoke, VA 24013-2256
Phone (540) 224-5170

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Dec 29, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Dec 29, 2024 Accepting new patients
Carilion Medical Center CurrentSince Dec 29, 2024 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Dec 29, 2024 Accepting new patients
Carilion Medical Center CurrentSince Dec 29, 2024 Accepting new patients

Locations

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

102 Highland Ave SE
Ste 303
Roanoke, VA 24013
Phone (540) 344-3020

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: cmanahan164941@direct.carilionclinic.org

Organizations & group practices 5

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.

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": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1790506814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HIGHLAND AVE SE STE 303",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132253",
            "telephone_number": "540-985-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAHAN",
        "first_name": "CAITLIN",
        "middle_name": "MARY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024191636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.