Diane Mantos, RN, BSN, CCM

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

0001105385 Issued in VA

Practice address

12150 Monument Dr
Fairfax, VA 22033-4051

Phone

(757) 270-2452

Fax

(770) 723-8586

NPI assigned

Dec 16, 2021

Last updated

Dec 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1811656911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 NW 136TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232800",
            "telephone_number": "757-270-2452",
            "fax_number": "770-723-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 MONUMENT DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334051",
            "telephone_number": "757-270-2452",
            "fax_number": "770-723-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTOS",
        "first_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN, CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "VA",
            "license": "0001105385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manor Care-Fair Oaks of Fairfax VA LLC (ProMedica Skilled Nursing and Rehabilitation (Fair Oaks))
• Sandra M Mansfield, LCSW
• Max Manson
• Darlene Mansoor, M.D.
• Renu Sharaf Mansukhani, M.D.
• Alison Beth Mantua, PA-C
• Aileen Marie Mapalo, OT
• Maple Chiropractic & Acupuncture Clinic, LLC
• Ronica A Marable, PHD
• Alhaji Marah

• Case Management Registered Nurse in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Case Management Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.