Individual provider Active NPI

Latriece Eileena Manning, D.O.

  • Obstetrics & Gynecology Physician
  • Lumberton, NJ
National Provider Identifier
1861635203
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MB08520000 Issued in NJ
Practice address
1617 Route 38
Lumberton, NJ 08048-2919
Phone
(609) 261-0240
Fax
(609) 261-8622
NPI assigned
Apr 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS014622 PA
Obstetrics & Gynecology Physician 207V00000X 25MB08520000 NJ Primary

Addresses

Primary practice location

1617 Route 38
Lumberton, NJ 08048-2919

Mailing address

1617 Route 38
Lumberton, NJ 08048-2919
Phone (609) 261-0240

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address lmanning13474@directvirtua.org
Direct Messaging Address lmanning13474@directvirtua.org
Direct Messaging Address lmanning13474@directvirtua.org
Direct Messaging Address lmanning13474@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090623000334 NJ Practitioner - Obstetrics/Gynecology 4385795855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

175 Madison Ave
Mount Holly, NJ 08060-2038

3242 Route 206
Bordentown, NJ 08505-4517

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS014622PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Apr 1, 2016 Accepting new patients
Virtua Medical Group, PA CurrentSince Apr 1, 2016 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1600 Haddon Ave
Fl 4
Camden, NJ 08103
Phone (856) 757-3500

1617 Route 38
Lumberton, NJ 08048
Phone (609) 261-0020

1636 Route 38
Lumberton, NJ 08048
Phone (609) 261-7023

401 Young Ave
Ste 325
Moorestown, NJ 08057
Phone (800) 346-7834

175 Madison Ave
Fl 3
Mount Holly, NJ 08060
Phone (609) 914-6198

100 Bowman Dr
Fl 3
Voorhees, NJ 08043
Phone (856) 247-3000

200 Bowman Dr
Ste E340
Voorhees, NJ 08043
Phone (856) 247-7586

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1861635203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482919",
            "telephone_number": "609-261-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482919",
            "telephone_number": "609-261-0240",
            "fax_number": "609-261-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "LATRIECE",
        "middle_name": "EILEENA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS014622",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MB08520000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmanning13474@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 3",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmanning13474@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 325",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080574800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmanning13474@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 3",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmanning13474@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 4",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

Verify at the official NPI Registry.