Active NPI
Manju Kandula, M.D.
- Neurology Physician
- Nashville, TN
National Provider Identifier
1558304725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 23757
- Practice address
- 300 20TH Ave N
9TH Floor
Nashville, TN 37203-2131 - Phone
- (615) 284-1400
- Fax
- (615) 284-1535
- NPI assigned
- Jun 14, 2006
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 23757 | TN | Primary |
Addresses
Primary practice location
300 20TH Ave N
9TH Floor
Nashville, TN 37203-2131
Mailing address
PO Box 501123
Saint Louis, MO 63150-0001
Phone (615) 284-1400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5152045 | Other | TN | AETNA |
| 130024217 | Other | TN | RR MEDICARE |
| 3096859 | Medicaid | TN | |
| 4018251 | Other | TN | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23757 | TN | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1558304725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 501123",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631500001",
"telephone_number": "615-284-1400",
"fax_number": "615-284-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 20TH AVE N",
"address_2": "9TH FLOOR",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372032131",
"telephone_number": "615-284-1400",
"fax_number": "615-284-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANDULA",
"first_name": "MANJU",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "23757",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5152045",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "130024217",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3096859",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4018251",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.