DR. MANGALA VENKATESH (NPI# 1265411029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265411029 |
| Entity Type | Individual |
| Full Name | DR. MANGALA VENKATESH |
| Credential | M.D. |
| Practice Address |
2300 Miami Valley Dr Ste 550 Centerville OH 45459-1298 |
| Mailing Address |
3170 Kettering Blvd Bldg B3 Moraine OH 45439-1924 |
| Practice Telephone | 9374387500 |
| Practice Fax Number | 9374387555 |
| Mailing Telephone | 9379913188 |
| Mailing Fax Number | 9372239811 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
35045891 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0496020 | 05 | |
| OH | CIGNA | 7138684001 | 01 |
| OH | ANTHEM | 3160053075G36 | 01 |
| OH | CHOICECARE | D45891 | 01 |
| OH | UNITED HEALTHCARE | 0520032 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 630 W Main St, Suite 207, Wilmington, OH 451772170 | 9373825438 | 9373825260 |
| Street Address |
2300 MIAMI VALLEY DR STE 550 |
| City | CENTERVILLE |
| State | OH |
| Zip Code | 45459-1298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063538783 | Marie Elizabeth Chambers | Nurse Practitioner | 2300 Miami Valley Dr Ste 550, Centerville, OH 45459-4779 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917466 | Sarai Burke Robinson | Occupational Therapist | 2200 Miami Valley Rd, Dayton, OH 45459 | 2019-11-27 |
| 1689179855 | Paragon Infusion Therapy, LLC | Durable Medical Equipment & Medical Supplies | 1746 Thomas Paine Pkwy, Centerville, OH 45459 | 2018-03-28 |
| 1922555473 | Hannah Gualtieri | Specialist/Technologist | Miami Valley Drive, Suite 320, Centerville, OH 45459 | 2016-09-01 |
| 1326410028 | Kathleen E Dorsten | Counselor | 37 Irongate Park Dr, Centerville, OH 45459 | 2015-10-21 |
| 1184000846 | Valeriya Falkenshtern | Specialist/Technologist | 2400 Miami Valley Drive, Newborn Hearing Screens, Dayton, OH 45459 | 2015-08-05 |
| 1700169331 | Monica Lynn Carrico | Registered Nurse | 7625 Paragon Road Suite C, Dayton, OH 45459 | 2011-09-20 |
| 1427360080 | Tonia S Campbell | Physical Therapist | 1235 E. Alex Bell Road, Centerville, OH 45459 | 2010-07-11 |
| 1265768956 | Health At Home, LLC | Home Health | 6443 Bethany Village Drive, Dayton, OH 45459 | 2009-10-30 |
| 1881826337 | Annetta Jean Davis | Social Worker | 7950 Clyo Road, Centerville, OH 45459 | 2009-08-18 |
| 1740459783 | Ryan A Long | Dentist | 2591 Miamisburg-centerville Rd, Suite 200, Dayton, OH 45459 | 2008-02-25 |
| Find all providers in zip 45459 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528060399 | Kenneth Brian Pugar | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2005-08-11 |
| 1285005116 | Healthy Brain Neurology Corp | Psychiatry & Neurology | 6601 Centerville Business Pkwy, Centerville, OH 45459-2691 | 2015-10-19 |
| 1912274994 | Megan Linne Mackenzie | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2011-11-19 |
| 1932495157 | Jon Durrani | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2011-06-27 |
| 1699911586 | Sarah E Dooley | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2008-12-23 |
| 1790984045 | Eleina Mikhaylov | Psychiatry & Neurology | 2400 Miami Valley Dr, Centerville, OH 45459-4774 | 2007-07-17 |
| 1942261243 | Kenneth Alan Mankowski | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2006-03-28 |
| 1699740795 | Lenora E Gray | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2006-02-22 |
| 1033111802 | Timothy Lee Schoonover | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2005-08-11 |
| 1285636050 | Michael John Valle | Psychiatry & Neurology | 1975 Miamisburg Centerville Rd, Centerville, OH 45459-3811 | 2005-08-11 |
| Find all providers in CENTERVILLE | ||||
| City | CENTERVILLE |
| Zip Code | 45459 |
Please comment or provide details below to improve the information on DR. MANGALA VENKATESH.
| 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.