Active NPI
Madhu Mukkamala, BS., CNIM
- Electroneurodiagnostic Specialist/Technologist
- Englewood, CO
National Provider Identifier
1609177344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- License
- 1415
- Practice address
- 777 E Girard Ave
250
Englewood, CO 80113-2767 - Phone
- (720) 214-2549
- NPI assigned
- Nov 11, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | 1415 | NC | Primary |
Addresses
Primary practice location
777 E Girard Ave
250
Englewood, CO 80113-2767
Mailing address
777 E Girard Ave
250
Englewood, CO 80113-2767
Phone (720) 214-2549
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)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289433600000",
"number": "1609177344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 E GIRARD AVE",
"address_2": "250",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801132767",
"telephone_number": "720-214-2549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 E GIRARD AVE",
"address_2": "250",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801132767",
"telephone_number": "720-214-2549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKKAMALA",
"first_name": "MADHU",
"name_prefix": "Mr.",
"credential": "BS., CNIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-11",
"last_updated": "2010-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": "NC",
"license": "1415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.