Lisa Marie Mann, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11417 Issued in GA

Practice address

1401 Peachtree St NE Ste 105
Atlanta, GA 30309-3023

Phone

(293) 222-3304

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  Medicare reassignment Care Compare group
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284
  Medicare reassignment
• Florida Behavioral Center, Inc

  dba Florida Healthcare System

  • Community/Behavioral Health Agency
  • Doral, FL
  • NPI 1912334863
  NPD (past)

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1902371149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PEACHTREE ST NE STE 105",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093023",
            "telephone_number": "293-222-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PEACHTREE ST NE STE 105",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093023",
            "telephone_number": "293-222-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA PHYSICIAN ASSISTANT LICENSE NUMBER",
            "identifier": "11417",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA PHYSICIAN ASSISTANT LICENSE NUMBER",
            "identifier": "9111500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lalah Manly, M.ED.
• Brittany Michelle Mann
• Dyona Tashawn Mann
• Karen Mann, M.D., PH.D.
• Kayla Mann
• Marcy M. Mann, M.D.
• Margaret McSwain Mann, L.P.C. A.T.R.
• Molly Anna Mann, DC
• Nickolas Mann, RBT
• Michelle Manne, LMSW

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.