Individual provider Active NPI

Winfred C Manda, MD

  • Pulmonary Disease Physician
  • Chattanooga, TN
National Provider Identifier
1659384980
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
38183 Issued in TN
Practice address
1350 Mackey Branch Dr
Ste # 101
Chattanooga, TN 37421-3482
Phone
(423) 553-1155
Fax
(423) 553-1124
NPI assigned
Aug 15, 2006
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038183 TN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 038183 TN
Pulmonary Disease Physician 207RP1001X 38183 TN Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 038183 TN

Addresses

Primary practice location

1350 Mackey Branch Dr
Ste # 101
Chattanooga, TN 37421-3482

Mailing address

1350 Mackey Branch Dr
Ste #101
Chattanooga, TN 37421-3482
Phone (423) 553-1155

Other identifiers 1

IdentifierTypeStateIssuer
TN0101MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040317000883 TN Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 6709776354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine, Sleep Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1350 Mackey Branch Dr
Suite 101
Chattanooga, TN 37421-3482
Phone (423) 553-1155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038183TNMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Pulmonary & Sleep Disorders,PLLC CurrentSince Nov 2, 2005 Accepting new patients
Galen Medical Group, PC Internal Medicine PastSince Dec 1, 1993 Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients

Locations

1350 Mackey Branch Dr
Ste 101
Chattanooga, TN 37421
Phone (423) 322-9525

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADJDBA/Endpoint/ADJDBA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1659384980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 MACKEY BRANCH DR",
            "address_2": "STE #101",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213482",
            "telephone_number": "423-553-1155",
            "fax_number": "423-553-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MACKEY BRANCH DR",
            "address_2": "STE # 101",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213482",
            "telephone_number": "423-553-1155",
            "fax_number": "423-553-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDA",
        "first_name": "WINFRED",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "038183",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "038183",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "38183",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TN",
            "license": "038183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TN0101",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.