Manjuka Wijewardena, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1101444 Issued in TX

Practice address

920 Medical Plaza Dr Ste 450
Shenandoah, TX 77380-3204

Phone

(281) 364-1700

Fax

(281) 364-1710

NPI assigned

Feb 10, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwijewardena67067@memorialhermann.direct-ci.com

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.

• Spring Telehealth

  • Clinic/Center
  • Spring, TX
  • NPI 1780530550
  NPD Authorized official
• High Tech Family Care and Women'S Health PA

  • Family Medicine Physician
  • Shenandoah, TX
  • NPI 1902908379
  NPD

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1902503840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30411 RUSSELL POINT DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773863448",
            "telephone_number": "361-232-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MEDICAL PLAZA DR STE 450",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803204",
            "telephone_number": "281-364-1700",
            "fax_number": "281-364-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJEWARDENA",
        "first_name": "MANJUKA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1101444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie K Wheeler, AUD, CCC-A
• Thomas Sumner White, M.D.
• Brianna Whitener, PA-C
• Brooke Whitley, MA, LPC, NCC
• Elaina Wickman, PA
• Darrell Wallace Wilcox, M.D.
• Mitchell William, PT, DPT
• Jocelyn Williams
• Zachary Marshall Williams, FNP-C
• Sarah Willis

• Family Nurse Practitioner in Shenandoah, TX
• Providers in Shenandoah, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.