Andrew J Mandery MD LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ANDREW J MANDERY MD LLC

Practice address

1948 W Boulevard
Kokomo, IN 46902-6078

Phone

(765) 236-1290

Fax

(765) 236-0420

NPI assigned

Sep 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Jay Mandery, M.D.

Title

Owner

Phone

(765) 236-1290

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1922294115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026078",
            "telephone_number": "765-236-1290",
            "fax_number": "765-236-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026078",
            "telephone_number": "765-236-1290",
            "fax_number": "765-236-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J MANDERY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "MANDERY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-236-1290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NO.",
            "identifier": "148380",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John R. Anderson, MA
• Lashelle M Anderson, FNP-C
• Loni Anderson, RBT
• Melissa Anderson, RBT
• Rachel Anderson
• Andrew Mandery MD Plastic Surgery LLC
• Jayda Andrews, RBT
• Megan Andrews
• Stanton Angermeier, MD
• Aspen Nichole Anglin, RBT

• Clinic/Center in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.