Kimberly Renee Manina, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Loranger, LA
NPI 1851663306 · NPPES record last updated Oct 25, 2016
Key facts
- NPI
- 1851663306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP06729 (LA)
- Practice address
- 54033 Highway 1062
Suite B
Loranger, LA 70446-3538 - Phone
- (985) 606-2273
- Fax
- (985) 606-2268
- NPI assigned
- Jan 30, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Healthcare of Loranger LLC
Practice addresses (Care Compare)
54002 Hwy 1062
Loranger, LA 70446-3538
Phone (985) 606-2273
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Family Healthcare of Loranger LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) W-2 Managing Employee (100%) |
Nov 30, 2015 Nov 30, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120611000264 | LA | Practitioner - Nurse Practitioner | 2466616115 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare of Loranger, LLC | Current |
Accepting new patients | |
| Franklinton Family Medicine, LLC | Family | Past | Accepting new patients |
| 360 Therapy, LLC | Past |
Accepting new patients | |
| Lakeview Regional Physician Group LLC | Past | Accepting new patients |
Locations
54002 Highway 1062
Loranger, LA 70446
Phone (985) 606-2273
54002 Highway 1062
Ste B
Loranger, LA 70446
Phone (985) 606-2273
54033 Highway 1062
#B
Loranger, LA 70446
Phone (225) 209-7140
54002 Highway 1062
Ste A
Loranger, LA 70446
Interoperability endpoints
- kimberly.manina.1@11757.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP06729 | LA | Yes |
Addresses
Primary practice location
54033 Highway 1062
Suite B
Loranger, LA 70446-3538
Mailing address
54033 Highway 1062
Suite B
Loranger, LA 70446-3538
Phone (985) 606-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2194089 | Medicaid | LA |
Other providers in Loranger, LA
- Life-Line Health Care
- Lighthouse Ranch for Boys Inc.
- Tikesha Shalonda Lindsey
- Louisiana United Methodist Children & Family Services, Inc
- Tuneea Magee
- Regina Aucoin Margavio
- Leslie Anne McDaniel
- Ashleye Dunbar McElrath
- Lyman Allan Mizell
- Sherie Naquin
All providers in Loranger, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.