Individual provider Active NPI

Lynn Y Mann, DO

  • Pediatrics Physician
  • Blackwood, NJ
National Provider Identifier
1841255148
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MB04780400 Issued in NJ
Practice address
527 S Black Horse Pike
Blackwood, NJ 08012-2868
Phone
(856) 228-1061
Fax
(856) 228-1907
NPI assigned
Apr 19, 2006
Last updated
Jan 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MB04780400 NJ Primary

Addresses

Primary practice location

527 S Black Horse Pike
Blackwood, NJ 08012-2868

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130301000116 VT Practitioner - Pediatric MedicinePractitioner - Family Practice 0143475889 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB04780400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Vermont Medical Center Inc. Pediatrics CurrentSince Dec 31, 2012 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Dec 31, 2012 Accepting new patients
Southwestern Vermont Medical Center, Inc Past Accepting new patients

Locations

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

140 Hospital Dr
Ste 210
Bennington, VT 05201
Phone (802) 447-3930

5957 Main St
Manchestr Ctr, VT 05255
Phone (802) 362-4440

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1841255148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 S BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122868",
            "telephone_number": "856-228-1061",
            "fax_number": "856-228-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "LYNN",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB04780400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, NJ

Sources for this page

Verify at the official NPI Registry.