Active NPI
Sai Sudha Mannemuddhu, MD
- Pediatric Nephrology Physician
- Knoxville, TN
National Provider Identifier
1043626054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- 60783
- Practice address
- 2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220 - Phone
- (865) 546-3111
- Fax
- (877) 761-6691
- NPI assigned
- Jul 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nephrology Physician | 2080P0210X | 60783 | TN | Primary |
Addresses
Primary practice location
2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220
Mailing address
PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8895
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q056987 | Medicaid | TN |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60783 | TN | MD | Pediatric Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1043626054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15004",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379015004",
"telephone_number": "865-541-8895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 CLINCH AVE STE 310",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379162220",
"telephone_number": "865-546-3111",
"fax_number": "877-761-6691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNEMUDDHU",
"first_name": "SAI SUDHA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-10",
"last_updated": "2025-02-14",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "TN",
"license": "60783",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q056987",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.