Manohar R. Manchandia, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

05497R Issued in LA

Practice address

2706 Shed Rd
Bossier City, LA 71111-3348

Phone

(318) 747-5272

Fax

(318) 746-9669

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmanchand@direct.wkhs.com

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.

• Willis Knighton Medical Center & M R Manchandia

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1992731301
  NPD (past)
• WK Center for Pediatric Gastroenterology

  • Pediatric Gastroenterology Physician
  • Shreveport, LA
  • NPI 1720620784
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1023086873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 SHED RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113348",
            "telephone_number": "318-747-5272",
            "fax_number": "318-746-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 SHED RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113348",
            "telephone_number": "318-747-5272",
            "fax_number": "318-746-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHANDIA",
        "first_name": "MANOHAR",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "05497R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zabrina Dishelle Mack, RN
• April Macon
• Emily Rene Maddox, ACNPC-AG
• Alexis B Maitland, LMSW
• Margo Malone
• Brea Manning
• Shawn Michael Manor, PHARM.D.
• Stacy Manor, PHARMD
• Janessa L Maple
• Christie C Maranto, APRN-BC,FNP

• Pediatrics Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.