Individual provider Active NPI

Karen A Mannino, FNP

  • Family Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1871634188
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71001692A Issued in IN
Practice address
10607 Randolph St
Ste C
Crown Point, IN 46307-7505
Phone
(219) 663-1841
Fax
(219) 663-1846
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71001692A IN Primary

Addresses

Primary practice location

10607 Randolph St
Ste C
Crown Point, IN 46307-7505

Mailing address

10607 Randolph St
Ste C
Crown Point, IN 46307-7505
Phone (219) 663-1841

Other identifiers 1

IdentifierTypeStateIssuer
201001970MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20110121000348 IN Practitioner - Nurse Practitioner 1456530575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

1400 S Lake Park Ave
Suite 205
Hobart, IN 46342-6791
Phone (219) 942-8620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001692AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Jul 1, 2012 Accepting new patients
219 Health Network, Inc. Past Accepting new patients

Locations

10607 Randolph St
Ste A
Crown Point, IN 46307
Phone (219) 226-1529

10607 Randolph St
Ste C
Crown Point, IN 46307
Phone (219) 226-1895

1400 S Lake Park Ave
Ste 205
Hobart, IN 46342
Phone (219) 942-8620

164 Bracken Pkwy
Hobart, IN 46342
Phone (219) 942-1145

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

3800 Saint Mary Rd
Ste 201
Valparaiso, IN 46383
Phone (219) 286-3775

Interoperability endpoints

  • Direct secure messaging: kmannino4261@ssdirect.comhs.org

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.

Hospital & facility affiliations 4

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1871634188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10607 RANDOLPH ST",
            "address_2": "STE C",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077505",
            "telephone_number": "219-663-1841",
            "fax_number": "219-663-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10607 RANDOLPH ST",
            "address_2": "STE C",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077505",
            "telephone_number": "219-663-1841",
            "fax_number": "219-663-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINO",
        "first_name": "KAREN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001692A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201001970",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.