Individual provider Active NPI

Krishnaveni Manku

  • Emergency Medical Services (Emergency Medicine) Physician
  • Valley, AL
National Provider Identifier
1497854293
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
00027650 Issued in AL
Practice address
4800 48TH St
Valley, AL 36854-3666
Phone
(334) 756-9180
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 00027650 AL Primary

Addresses

Primary practice location

4800 48TH St
Valley, AL 36854-3666

Mailing address

PO Box 686
West Point, GA 31833-0686
Phone (706) 643-1073

Other identifiers 1

IdentifierTypeStateIssuer
00027650OtherALSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070611000433 AL Practitioner - Family PracticePractitioner - Emergency Medicine 6800994104 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00027650ALMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Inc Current Accepting new patients
Community Hospital Inc Current Accepting new patients
Emergency Staffing Solutions Inc CurrentSince Nov 22, 2012 Accepting new patients
Community Hospital Inc CurrentSince Feb 25, 2011 Accepting new patients
Community Hospital, Inc CurrentSince Feb 25, 2011 Accepting new patients
Emergency Medical Specialist Past Accepting new patients
Shawmut Emergency Physicians Past Accepting new patients

Locations

401 S 8th Ave
Atmore, AL 36502
Phone (251) 368-2500

805 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-6541

4800 48th St
Valley, AL 36854
Phone (334) 756-1401

Organizations & group practices 7

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497854293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "WEST POINT",
            "state": "GA",
            "postal_code": "318330686",
            "telephone_number": "706-643-1073",
            "fax_number": "706-643-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 48TH ST",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368543666",
            "telephone_number": "334-756-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKU",
        "first_name": "KRISHNAVENI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AL",
            "license": "00027650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "00027650",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley, AL

Sources for this page

Verify at the official NPI Registry.