Individual provider Active NPI

Ghalib Mannan, M.D.

  • Infectious Disease Physician
  • Memphis, TN
National Provider Identifier
1831144013
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
17199 Issued in MS
Practice address
6029 Walnut Grove Rd Ste 209
Memphis, TN 38120-2112
Phone
(901) 681-0778
Fax
(901) 821-9987
NPI assigned
May 24, 2006
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 17199 MS Primary

Addresses

Primary practice location

6029 Walnut Grove Rd Ste 209
Memphis, TN 38120-2112

Mailing address

6029 Walnut Grove Rd Ste 209
Memphis, TN 38120-2112
Phone (901) 681-0778

Other practice location 1

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (901) 681-0778

Other identifiers 3

IdentifierTypeStateIssuer
3865813MedicaidTN
3865814MedicaidTN
000124232MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040406000843 TN Practitioner - Infectious Disease 0345232922 Reassigns benefits to 1 organization
I20040511001208 MS Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345232922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Infectious Disease Associates, PLLCGroup PAC ID 0547252124, 12 clinicians

Practice addresses (Care Compare)

6029 Walnut Grove Rd
Suite 209
Memphis, TN 38120-2112
Phone (901) 681-0778

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 349-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
90.59
Promoting interoperability
100
Improvement activities
40
Cost
81.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Infectious Disease Associates, PLLC Infectious Disease CurrentSince Apr 1, 2004 Accepting new patients
Advanced Kidney Care PastSince Feb 14, 2013 Accepting new patients

Locations

401 Southcrest Cir
Ste 201
Southaven, MS 38671
Phone (662) 772-4000

401 Southcrest Cir
Ste 203
Southaven, MS 38671
Phone (662) 775-4025

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

6027 Walnut Grove Rd
Ste 312
Memphis, TN 38120
Phone (901) 681-0778

6029 Walnut Grove Rd
Ste 209
Memphis, TN 38120
Phone (901) 681-0778

Interoperability endpoints

  • Direct secure messaging: gmannan13264@direct.bmhcc.org
  • Direct secure messaging: gmannan26352@mlh.direct-ci.com

Organizations & group practices 2

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 7

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1831144013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD STE 209",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-681-0778",
            "fax_number": "901-821-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD STE 209",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-681-0778",
            "fax_number": "901-821-9987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 Southcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714739",
            "country_code": "US",
            "telephone_number": "901-681-0778",
            "fax_number": "901-821-9987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNAN",
        "first_name": "GHALIB",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "17199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3865813",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3865814",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000124232",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.