Active NPI
Manu Nanda, M.D.
- Specialist
- St Petersburg, FL
National Provider Identifier
1699760843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME0044026
- Practice address
- 4801 49TH St N
St Petersburg, FL 33709-3859 - Phone
- (727) 526-3468
- Fax
- (727) 522-3369
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | ME0044026 | FL | Primary |
Addresses
Primary practice location
4801 49TH St N
St Petersburg, FL 33709-3859
Mailing address
4801 49TH St N
St Petersburg, FL 33709-3859
Phone (727) 526-3468
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036253100 | Medicaid | FL |
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 |
|---|---|---|---|
| ME0044026 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1699760843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 49TH ST N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337093859",
"telephone_number": "727-526-3468",
"fax_number": "727-522-3369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 49TH ST N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337093859",
"telephone_number": "727-526-3468",
"fax_number": "727-522-3369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANDA",
"first_name": "MANU",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME0044026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036253100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.