Individual provider Active NPI

Karen E Mann, PA-C

  • Physician Assistant
  • Tarboro, NC
National Provider Identifier
1912954223
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00221 Issued in NC
Practice address
111 Hospital Dr
Tarboro, NC 27886-2011
Phone
(252) 641-7700
Fax
(252) 641-7477
NPI assigned
May 30, 2006
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00221 NC Primary

Addresses

Primary practice location

111 Hospital Dr
Tarboro, NC 27886-2011

Mailing address

624 W Main St
Washington, NC 27889-4836
Phone (252) 946-3908

Other practice location 1

1204 E Fire Tower Rd
Greenville, NC 27858-4196
Phone (252) 744-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20051107000413 NC Practitioner - Physician Assistant 6608893219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-00221NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Dec 1, 2009 Accepting new patients
Vidant Medical Group LLC CurrentSince Dec 1, 2009 Accepting new patients

Locations

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1912954223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W MAIN ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894836",
            "telephone_number": "252-946-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862011",
            "telephone_number": "252-641-7700",
            "fax_number": "252-641-7477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1204 E Fire Tower Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278584196",
            "country_code": "US",
            "telephone_number": "252-744-1122",
            "fax_number": "252-744-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "KAREN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

Verify at the official NPI Registry.