Shantaveer Gangu (NPI# 1053670273, PAC ID# 5294047056) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PEDIATRIC MEDICINE.
| Nation Provider ID (NPI) | 1053670273 |
| PAC ID by PECOS | 5294047056 |
| Professional Enrollment ID | I20160811000760 |
| Full Name | Shantaveer Gangu |
| Organization Legal Name | UT LEBONHEUR PEDIATRIC SPECIALISTS, INC. |
| Address |
848 Adams Ave Memphis TN 38103-2816 |
| Gender | M |
| Graduation Year | 2005 |
| Primary Specialty | PEDIATRIC MEDICINE |
| Secondary Specialties | CRITICAL CARE (INTENSIVISTS) |
| Group Practice PAC ID | 7719173939 |
| Number of Group Practice Members | 115 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440049 | METHODIST HEALTHCARE MEMPHIS HOSPITALS |
| Address | Phone | Organization |
|---|---|---|
| 770 Estate Place, Memphis, TN 38120-0600 | 9012874030 | UT LEBONHEUR PEDIATRIC SPECIALISTS, INC. |
| 848 Adams Ave, Memphis, TN 38103-2816 | UT LEBONHEUR PEDIATRIC SPECIALISTS, INC. |
| Organization Legal Name | UT LEBONHEUR PEDIATRIC SPECIALISTS, INC. |
| Physicians | 176 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin S Hendrickson | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 51 N Dunlap, Suite 235, Memphis, TN 38105 |
| Eileen F Smith | Qualified Audiologist | Ut Lebonheur Pediatric Specialists, Inc. | 4055 N Park Loop, Memphis, TN 38152-4220 |
| Casandra B Banks | Qualified Audiologist | Ut Lebonheur Pediatric Specialists, Inc. | 770 Estate Place, Memphis, TN 38120-0600 |
| Benjamin R Waller Iii | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Jennifer D Mclevy-bazzanella | Otolaryngology | Ut Lebonheur Pediatric Specialists, Inc. | 51 N Dunlap St, Memphis, TN 38105-4624 |
| Glenn T Wetzel | Cardiovascular Disease (cardiology) | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Mark C Bugnitz | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Miriam Vanmersbergen | Qualified Speech Language Pathologist | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Tonia Elizabeth Gardner | Neurology | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Natalie C Kerr | Ophthalmology | Ut Lebonheur Pediatric Specialists, Inc. | 770 Estate Place, Memphis, TN 38120-0600 |
| Street Address |
848 ADAMS AVE |
| City | MEMPHIS |
| State | TN |
| Zip | 38103-2816 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin R Waller Iii | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Glenn T Wetzel | Cardiovascular Disease (cardiology) | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Mark C Bugnitz | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Miriam Vanmersbergen | Qualified Speech Language Pathologist | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Tonia Elizabeth Gardner | Neurology | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Anthony M Sheyn | Otolaryngology | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Anthony C Merlocco | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Shyam Sathanandam | Pediatric Medicine | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Vijakumar Agrawal | Interventional Radiology | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Preet K Sandhu | Diagnostic Radiology | Ut Lebonheur Pediatric Specialists, Inc. | 848 Adams Ave, Memphis, TN 38103-2816 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Rhea Miller | Internal Medicine | Ut Regional One Physicians Inc | 718 Harbor Bend Rd, Memphis, TN 38103-0888 |
| Tomisha Byard | Nurse Practitioner | Ut Regional One Physicians Inc | 718 Harbor Bend Rd, Memphis, TN 38103-0888 |
| Matthew C Hayden | Chiropractic | 45 N 3rd St, Suite 101, Memphis, TN 38103-2354 | |
| Daniel Edward Brezina | Anesthesiology | Pediatric Anesthesiologists P A | 50 N Dunlap St, Memphis, TN 38103-2800 |
| Timothy Alan Head | Anesthesiology | Pediatric Anesthesiologists P A | 50 N Dunlap, Memphis, TN 38103-2800 |
| Kristen B Davis | Certified Registered Nurse Anesthetist (crna) | Pediatric Anesthesiologists P A | 50 N Dunlap St, Memphis, TN 38103-2800 |
| James R. Antony Bradley | Anesthesiology | Pediatric Anesthesiologists P A | 50 N Dunlap St, Memphis, TN 38103-2800 |
| Erica Grissom | Certified Registered Nurse Anesthetist (crna) | Pediatric Anesthesiologists P A | 50 N Dunlap St, Memphis, TN 38103-2800 |
| Thomas Boyce Hamilton | Anesthesiology | Pediatric Anesthesiologists P A | 50 N Dunlap St, Memphis, TN 38103-2800 |
| Adam P Willis | Anesthesiology | Pediatric Anesthesiologists P A | 50 N Dunlap St, Memphis, TN 38103-2800 |
| Find all physicians in zip 38103 | |||
| City | MEMPHIS |
| Zip Code | 38103 |
| Specialty | PEDIATRIC MEDICINE |
| City + Specialty | MEMPHIS + PEDIATRIC MEDICINE |
Please comment or provide details below to improve the information on Shantaveer Gangu.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.