Individual provider Active NPI

Manjit Vohra, MD

  • Psychiatry Physician
  • Winter Haven, FL
National Provider Identifier
1497866024
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME131172 Issued in FL
Practice address
200 Avenue F NE
Winter Haven, FL 33881-4131
Phone
(727) 519-1839
Fax
(727) 519-1830
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 249908 NY
Psychiatry Physician 2084P0800X 0101236052 VA
Psychiatry Physician 2084P0800X ME131172 FL Primary

Addresses

Primary practice location

200 Avenue F NE
Winter Haven, FL 33881-4131

Mailing address

200 Avenue F NE
Winter Haven, FL 33881-4131
Phone (727) 519-1839

Other identifiers 3

IdentifierTypeStateIssuer
010306639MedicaidVA
03540136MedicaidNY
P00361881OtherVAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040720001238 VA Practitioner - Psychiatry 6901708361 Reassigns benefits to 1 organization
I20170814000553 FL Practitioner - Psychiatry 6901708361 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249980NYMDLicensed Practical Nurse
249908NYMDPsychiatry Physician
0101236052VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Jun 17, 2017 Accepting new patients
Center of Revitalizing Psychiatry, P.C. Psychiatry CurrentSince Oct 1, 2017 Accepting new patients
Metropolitan Behavioral Services LLC CurrentSince Apr 1, 2020 Accepting new patients
Highlands Community Services CurrentSince Mar 4, 2019 Accepting new patients
MCR Health, Inc. CurrentSince Jun 17, 2017 Accepting new patients
Center of Revitalizing Psychiatry PC PastSince Oct 1, 2017 Accepting new patients

Locations

4500 Salisbury Rd
Ste 490
Jacksonville, FL 32216
Phone (904) 562-1391

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

2033 Wood St
Ste 220
Sarasota, FL 34237
Phone (941) 677-3366

610 Campus Dr
Abingdon, VA 24210
Phone (276) 525-1550

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1497866024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "727-519-1839",
            "fax_number": "727-519-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "727-519-1839",
            "fax_number": "727-519-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOHRA",
        "first_name": "MANJIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "249908",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101236052",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME131172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010306639",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03540136",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00361881",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.