Deepthi Seekuri Manoj, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036138351 Issued in IL

Practice address

1900 E Lake Shore Dr
Decatur, IL 62521-3824

Phone

(217) 423-2889

NPI assigned

Mar 6, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1881935435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213824",
            "telephone_number": "217-423-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213824",
            "telephone_number": "217-423-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEEKURI MANOJ",
        "first_name": "DEEPTHI",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036138351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark David Scott, M.D.
• Amy Nichole Scrimpsher, MSW
• Ashlyn Scriven, RBT
• Cierra Seals
• Laura Elizabeth Sechrest, R.D.
• Judith Anne Selle, RN MS CNOR CRPFA
• Sharon Rose Seman, CRNA
• Delanie Senesac
• Sensible Hearing
• Naudare Michael Shabandi, M.D.

• Pediatrics Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.