Anitha Mandadapu, M.D

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

42490 Issued in KY

Practice address

2700 Vissing Park Rd
Jeffersonville, IN 47130-5989

Phone

(812) 284-8000

Fax

(502) 805-0690

NPI assigned

Feb 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Abs Lincs Ky, LLC

  • Psychiatry Physician
  • Hopkinsville, KY
  • NPI 1720353501
  Medicare reassignment NPD
• Kmi Acquisition LLC

  • Psychiatric Hospital
  • Louisville, KY
  • NPI 1104097021
  Medicare reassignment NPD
• Kmi Acquisition LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1073194585
  NPD
• Wellstone Regional Hospital Acquisition LLC

  • Psychiatric Hospital
  • Jeffersonville, IN
  • NPI 1841215985
  NPD (past)
• Abs Lincs Ky, LLC

  • Psychiatric Hospital
  • Hopkinsville, KY
  • NPI 1750392502
  NPD (past)
• TBD Acquisition LLC

  • Psychiatric Hospital
  • Louisville, KY
  • NPI 1013188937
  NPD (past)

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1699816744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "address_2": "SUITE#340",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021954",
            "telephone_number": "502-589-8600",
            "fax_number": "502-589-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 VISSING PARK RD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305989",
            "telephone_number": "812-284-8000",
            "fax_number": "502-805-0690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19100 Brickshire Pl",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402456237",
            "country_code": "US",
            "telephone_number": "502-817-0927",
            "fax_number": "502-805-0690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDADAPU",
        "first_name": "ANITHA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "42490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johana Maldonado
• Abdulraheem Malik
• Brenna Shae Malone, BS
• Micheal Malone
• Ryan J Malone, M.D.
• Donna S Mann, MSW, LCSW
• Jacob Mann, RBT
• Jacqueline Mannen, BS
• Patri Marie Marconi, MD
• Courtney Nicole Marcum, RBT

• Child & Adolescent Psychiatry Physician in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Child & Adolescent Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.