DR. PRASHANTH SIRIGERE MANJUNATH (NPI# 1629227616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629227616 |
Entity Type | Individual |
Full Name | DR. PRASHANTH SIRIGERE MANJUNATH |
Credential | M.D |
Practice Address |
98 Poplar St Blackfoot ID 83221-1758 |
Practice Telephone | 2087823701 |
Mailing Telephone | 2087823701 |
Enumeration Date | 2008-09-15 |
Last Update Date | 2016-01-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
M11963 | ID | Allopathic & Osteopathic Physicians |
Street Address |
98 POPLAR ST |
City | BLACKFOOT |
State | ID |
Zip Code | 83221-1758 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609871474 | Wade H Flowers Jr. | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2005-06-16 |
1629685177 | Lucus Craig Webb Christoffersen | Registered Nurse | 98 Poplar St, Blackfoot, ID 83221-1799 | 2020-09-29 |
1770111924 | Kywnynn Madsen | Dietitian, Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2020-03-31 |
1235795915 | Megan Lewis | Advanced Practice Midwife | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-05-17 |
1083177935 | Jason Lee Harmon | Student in an Organized Health Care Education/Training Program | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-04-08 |
1851870091 | Jennifer L Wistisen | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1799 | 2018-08-08 |
1114405396 | Ryan Blair Killpack | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-31 |
1023504651 | Amanda Wray | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-06 |
1699268276 | Zachary D Morrow | Nurse Anesthetist, Certified Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-06-08 |
1184115107 | Megan Nicole Broyles | Pharmacist | 98 Poplar St, Blackfoot, ID 83221 | 2018-05-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
Find all providers in zip 83221 |
Taxonomy Code | 207LP2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Anesthesiology |
Specialization | Pain Medicine |
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
1649460130 | Bmh, Inc. | Anesthesiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2007-07-31 |
1255539193 | Bmh, Inc. | Anesthesiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2007-07-03 |
1275746646 | Gary D Call | Anesthesiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2007-05-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
1114171519 | Advanced Pain Management Pllc | Anesthesiology | 2275 So Eagle Rd, Sute 160, Meridian, ID 83642 | 2008-11-11 |
1235472531 | Eli J Harris | Anesthesiology | 4424 E Flamingo, Ste 310, Nampa, ID 83687 | 2013-04-04 |
1801143029 | Teton Valley Health Care, Inc | Anesthesiology | 83 N Main St, Victor, ID 83455-0368 | 2012-08-07 |
1154681633 | Daric J Russell | Anesthesiology | 3385 Potomac Way, Idaho Falls, ID 83404-4978 | 2012-05-18 |
1992070809 | Pain Specialists of Idaho | Anesthesiology | 2375 E Sunnyside Rd Ste J, Idaho Falls, ID 83404-8281 | 2012-03-12 |
1669785192 | Wind River Pain Management Pllc | Anesthesiology | 1975 Martha Ave, Suite B, Idaho Falls, ID 83404-7580 | 2010-07-26 |
1366622300 | Cornerstone Anesthesia Pa | Anesthesiology | 2841 Juniper Dr, Lewiston, ID 83501-4719 | 2007-11-07 |
1578760518 | Bmh, Inc. | Anesthesiology | 2375 E Sunnyside Rd, Idaho Falls, ID 83404-8280 | 2007-07-02 |
1881897932 | Ryan Don Hope | Anesthesiology | 2240 E Center St, Pocatello, ID 83201 | 2007-06-07 |
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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.