Koti R Mannem is a Psychiatry Physician practicing in Green Bay, Wisconsin. The National Provider Identifier (NPI) is #1720188717, which was assigned on September 22, 2006, and the registration record was last updated on March 17, 2025. The practitioner's main practice location is at 3150 Gershwin Drive, Green Bay, WI 54311-5859; the contact telephone number is 9203914700, and the fax number is 9203914870. The primary taxonomy of Koti R Mannem is Psychiatry Physician (2084P0800X), with specialization in Psychiatry. Koti R Mannem is licensed to practice in the state of Wisconsin (#24001).
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
| NPI | 1720188717 |
| Entity Type | Individual |
| Provider Name | DR. KOTI R MANNEM |
| Gender | Male |
| Credential | MD |
| Practice Address |
3150 Gershwin Drive Green Bay WI 54311-5859 |
| Practice Telephone | 9203914700 |
| Practice Fax Number | 9203914870 |
| Mailing Address |
3150 Gershwin Drive Green Bay WI 54311-5859 |
| Mailing Telephone | 9203914700 |
| Mailing Fax Number | 9203914870 |
| Certification Date | 2025-03-17 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-03-17 |
| Is Sole Proprietor | N |
| PAC ID |
7911964200 Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID |
| Full Name | KOTI R MANNEM |
| Primary Specialty | PSYCHIATRY |
| Organization Legal Name | ONEIDA COUNTY |
| Address |
705 E Timber Dr Rhinelander WI 54501-2859 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 2084P0800X | Psychiatry & Neurology | Psychiatry | 24001 | WI |
| Other Identifier | Issuing State | Issuer | Identifier Type |
|---|---|---|---|
| 1720188717 | WI | MEDICAID |
| Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
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|---|---|---|---|
| David Christopher Housley | 2555 N 2900 E, Layton, UT 84040-7672 | Psychiatry Physician | 2026-04-08 |
| Tyler Ballweg | 300 68th St Se, Grand Rapids, MI 49548-6927 | Psychiatry Physician | 2026-04-10 |
| Synapsis Mental Health, PLLC | 11125 Park Blvd Ste 104-267, Seminole, FL 33772-4757 | Psychiatry Physician | 2026-04-07 |
| Renewal Psychiatry & Wellness LLC | 2760 W Peoria Ave # 1103, Phoenix, AZ 85029-5202 | Psychiatry Physician | 2026-04-07 |
| Psychiatry of Colorado and The Southwest, PLLC | 315 W South Boulder Rd Ste 206, Louisville, CO 80027-1157 | Psychiatry Physician | 2026-04-08 |
| Brandy Renea Sanchez | 1910 Cherokee Ave Sw, Cullman, AL 35055-5502 | Psychiatry Physician | 2026-04-09 |
| Timothy Le Md PLLC | 101 Timberlachen Cir Ste 201, Lake Mary, FL 32746-6124 | Psychiatry Physician | 2026-04-07 |
| Lakeridge Psychiatry PLLC | 669 Airport Fwy Ste 401, Hurst, TX 76053-3964 | Psychiatry Physician | 2026-04-08 |
| Sandhu Behavioral Health Inc | 2132 Broken Rail Ln, Rocklin, CA 95765-5349 | Psychiatry Physician | 2026-04-08 |
| Flourish Health Medical Practice, Ltd. | 204 8th St., Marlinton, WV 24954 | Psychiatry Physician | 2026-04-10 |
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| Street Address |
3150 GERSHWIN DRIVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-5859 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Taylor Lauren Shefchik · Taylor Smiley | 2617 Development Dr, Green Bay, WI 54311-4240 | Physician Assistant | 2024-10-02 |
| Carrie Kraemer | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Clinical Social Worker | 2023-10-04 |
| Jacinda J Hecker | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Social Worker | 2024-07-09 |
| Eric J Tarsi | 2223 Lime Kiln Rd, Green Bay, WI 54311 | Physical Therapist | 2005-12-07 |
| County of Brown | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Case Management Agency | 2025-07-15 |
| Tyler G Luedke | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Addiction (Substance Use Disorder) Counselor | 2013-04-08 |
| Jamie Lee Noxon · Jamie Lee Johnston | 1496 Bellevue St # 101, Green Bay, WI 54311-4205 | Mental Health Counselor | 2020-10-26 |
| Jenna R Mobile | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Addiction (Substance Use Disorder) Counselor | 2026-01-31 |
| Grace Woods | 2605 Development Dr, Green Bay, WI 54311-4240 | Physician Assistant | 2025-09-03 |
| Logan Wilz | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Clinical Psychologist | 2023-09-25 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Ravi K Koti | 2494 Sw 19th Avenue Rd, Ocala, FL 34471-7859 | Medical Oncology Physician | 2006-06-19 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |