DR. VIKRAM REDDY MANDADI (NPI# 1598852436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598852436 |
| Entity Type | Individual |
| Full Name | DR. VIKRAM REDDY MANDADI |
| Credential | MD |
| Practice Address |
6507 Professional Pl Riverdale GA 30274-4941 |
| Practice Telephone | 7709912100 |
| Practice Fax Number | 7709911385 |
| Mailing Telephone | 7709912100 |
| Mailing Fax Number | 7709911385 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2017-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 058798 | GA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
058798 | GA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
058798 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 659943665A | 05 | |
| GA | MEDICARE ID | 06CBBWF | 01 |
| Street Address |
6507 PROFESSIONAL PL |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-4941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043219256 | Bhat Krishna Mohan | Specialist | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2005-07-19 |
| 1114574258 | Brittany Lynne Jackson | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2019-08-22 |
| 1154781714 | Kellie Michelle Noble | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2016-02-24 |
| 1861736803 | Dipti Khanna | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2012-11-15 |
| 1376768259 | Minnette Williams | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2007-04-16 |
| 1215049440 | Siva B Mohan | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-09-01 |
| 1639128531 | Southern Heart Specialists, P.C. | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-05-08 |
| 1265495444 | Kandathil M. Mathew | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| 1659334829 | Devendra R Koganti | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| 1902869084 | Kuchela Reddy | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669019394 | Champ Vascular, LLC | Internal Medicine | 1825 Highway 34 E Ste 3400, Newnan, GA 30265-6423 | 2019-12-02 |
| 1174006159 | Kendall M Griffith Md LLC | Internal Medicine | 1497 Fair Rd Ste 311, Statesboro, GA 30458-0828 | 2018-09-14 |
| 1558869826 | Coordinated Health of Ga, LLC | Internal Medicine | 10 Glenlake Pkwy Ste 130c, Atlanta, GA 30328-3495 | 2018-01-31 |
| 1447559604 | David Brendan Casey | Internal Medicine | 1700 Tree Ln Ste 100, Snellville, GA 30078-6749 | 2011-03-26 |
| 1730404120 | Deepali Nivas Tukaye | Internal Medicine | 1505 Northside Blvd Ste 3400, Cumming, GA 30041-8223 | 2010-03-29 |
| 1659560647 | Oduwole Organization Inc | Internal Medicine | 1415 Highway 85 N Ste 310-296, Fayetteville, GA 30214-7738 | 2007-10-16 |
| 1053487462 | Tiftarea Cardiology | Internal Medicine | 907 E. 18th St, Ste 100, Tifton, GA 31794 | 2006-11-28 |
| 1255412094 | Jeetendra B Patel | Internal Medicine | 1301 Sigman Rd Ne Ste 200, Conyers, GA 30012 | 2006-10-18 |
| 1811082605 | Cardiac Disease Specialists, PC | Internal Medicine | 296 Merchants Sq, Dallas, GA 30132-5029 | 2006-10-04 |
| 1770508756 | Hunt Dandridge Anderson | Internal Medicine | 4500 Hospital Blvd, Suite 230, Roswell, GA 30076-0003 | 2006-07-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.