Prem P. Manchanda MD, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101057630 Issued in VA

Legal business name

PREM P. MANCHANDA MD, PC

Practice address

4660 Kenmore Ave
220
Alexandria, VA 22304-1313

Phone

(703) 981-4865

NPI assigned

May 17, 2011

Last updated

Nov 23, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prem Manchanda, M.D.NPI 1063578060

Title

Owner

Phone

(703) 981-4865

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9231/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prem Manchanda, M.D.

  • Internal Medicine Physician
  • Fairfax, VA
  • NPI 1063578060
  Authorized official Same address or phone

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1548553068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 ORCHARD DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220321021",
            "telephone_number": "703-981-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "220",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-981-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREM P. MANCHANDA MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "MANCHANDA",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-981-4865",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101057630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.