Individual provider Active NPI

Richard Anthony Mann Jr., FNP-BC

  • Family Nurse Practitioner
  • Cayce, SC
National Provider Identifier
1942228044
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
899 Issued in SC
Practice address
901 Lafayette Ave
Cayce, SC 29033-3224
Phone
(803) 791-3963
Fax
(803) 429-2134
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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 899 SC Primary

Addresses

Primary practice location

901 Lafayette Ave
Cayce, SC 29033-3224

Mailing address

PO Box 485
Columbia, SC 29202-0485
Phone (803) 898-8405

Other identifiers 1

IdentifierTypeStateIssuer
GP4350MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31580SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Urgent Care LLC CurrentSince Jan 2, 2020 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
Senior Health Associates, PA PastSince Jan 21, 2014 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

Locations

272 Robert Smalls Pkwy
Ste 320
Beaufort, SC 29906
Phone (843) 521-4357

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1942228044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020485",
            "telephone_number": "803-898-8405",
            "fax_number": "808-898-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LAFAYETTE AVE",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290333224",
            "telephone_number": "803-791-3963",
            "fax_number": "803-429-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4350",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayce, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.