Active NPI
Timothy David Mandrell, D.V.M.
- Veterinarian
- Memphis, TN
National Provider Identifier
1679815229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- DV0000002426
- Practice address
- 4862 Poplar Ave
Memphis, TN 38117-5152 - Phone
- (901) 496-7101
- Fax
- (901) 207-6438
- NPI assigned
- Mar 21, 2013
- Last updated
- Oct 6, 2020
- 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 |
|---|---|---|---|---|
| Veterinarian | 174M00000X | DV0000002426 | TN | Primary |
Addresses
Primary practice location
4862 Poplar Ave
Memphis, TN 38117-5152
Mailing address
4862 Poplar Ave
Memphis, TN 38117-5152
Phone (901) 496-7101
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DV0000002426 | TN | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1679815229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4862 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381175152",
"telephone_number": "901-496-7101",
"fax_number": "901-207-6438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4862 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381175152",
"telephone_number": "901-496-7101",
"fax_number": "901-207-6438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDRELL",
"first_name": "TIMOTHY",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.V.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-21",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "TN",
"license": "DV0000002426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.