NPIMap

Individual provider Active NPI

John Bennett Manna, NP-C

  • Family Nurse Practitioner
  • Lexington, SC
National Provider Identifier
1891311163
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24005 Issued in SC
Practice address
5336 Sunset Blvd Ste a
Lexington, SC 29072-9393
Phone
(803) 567-8900
Fax
(803) 567-8909
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 24005 SC Primary

Addresses

Primary practice location

5336 Sunset Blvd Ste a
Lexington, SC 29072-9393

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

103 Summit Centre Dr
Columbia, SC 29229-7613
Phone (803) 382-2450

Other identifiers 1

IdentifierTypeStateIssuer
NP6995MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmanna111777@direct.lexmed.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200914000729 SC Practitioner - Nurse Practitioner 7618395369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

5336 Sunset Blvd
Suite a
Lexington, SC 29072-9393
Phone (803) 434-3800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24005SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 12, 2022 Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Prisma Health Medical Group-Midlands Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 12, 2022 Accepting new patients
Lexington Health Inc Current Accepting new patients

Locations

103 Summit Centre Dr
Columbia, SC 29229
Phone (803) 356-4712

2 Medical Park Rd
Ste 203
Columbia, SC 29203
Phone (803) 212-7130

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

109 Barton Creek Ct
Columbia, SC 29229
Phone (803) 256-2286

4080 Augusta Hwy
Gilbert, SC 29054
Phone (803) 892-1800

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

5336 Sunset Blvd
Ste A
Lexington, SC 29072
Phone (803) 567-8900

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

935 W 2nd St
Swansea, SC 29160
Phone (803) 568-2000

Interoperability endpoints

  • Direct secure messaging: jmanna625296@direct.ghs.myhfn.org

Organizations & group practices 6

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 10

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1891311163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5336 SUNSET BLVD STE A",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729393",
            "telephone_number": "803-567-8900",
            "fax_number": "803-567-8909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Summit Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292297613",
            "country_code": "US",
            "telephone_number": "803-382-2450",
            "fax_number": "803-382-2469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNA",
        "first_name": "JOHN",
        "middle_name": "BENNETT",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6995",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmanna111777@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "103 Summit Centre Dr",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292297613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.