Individual provider Active NPI

Savitri Manda, M.D.

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1215981980
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008022991 Issued in MO
Practice address
4251 Northern Ave
Kansas City, MO 64133-1593
Phone
(816) 922-2366
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-31545 KS
Family Medicine Physician 207Q00000X 2008022991 MO Primary

Addresses

Primary practice location

4251 Northern Ave
Kansas City, MO 64133-1593

Mailing address

4251 Northern Ave
Kansas City, MO 64133-1593
Phone (816) 922-2366

Other identifiers 1

IdentifierTypeStateIssuer
1215981980MedicaidMO

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-31545KSMDFamily Medicine Physician
2008022991MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Encompass Medical Group, PA Family Medicine Past Accepting new patients
Graham County Hospital Family Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1215981980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 NORTHERN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641331593",
            "telephone_number": "816-922-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 NORTHERN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641331593",
            "telephone_number": "816-922-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDA",
        "first_name": "SAVITRI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-31545",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008022991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215981980",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.