Pavan Manchikalapati, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

069310 Issued in GA

Practice address

2509A S Main St
Moultrie, GA 31768-6530

Phone

(229) 785-2015

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Gaylord Hospital, Inc.

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  NPD (past)
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1689655318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1509",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317761509",
            "telephone_number": "229-785-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509A S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686530",
            "telephone_number": "229-785-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHIKALAPATI",
        "first_name": "PAVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "069310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135146A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Magat, DO
• Magnolia Wellness Group LLC
• Maison Health and Supportive Living LLC
• Noman Ahmed Malik, M.D.
• Laura Malone
• Michael Donald Marable, DMD
• Marion Counseling Services Inc
• Adam Marion
• Benajah Marion, LCSW, LMFT
• Arthur Clifford Marsh, M.D.

• Gastroenterology Physician in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.