NPI age
14 years
Enumerated 2012-05-22
● Active
Type 1 · Individual
Manjit Pakkala, MD
Pakkala is 1 of 45 internal medicine providers in Fayetteville and 1 of 5027 in Georgia.
Primary specialty
Internal Medicine
Plus 5 subspecialties
Licensed in
GA, MO, KS
3 states
Status
Active
No deactivations on record
Last NPPES update
2022-08-25
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 5027 active internal medicine providers in Georgia.
NPI age
14 years
↓ 4 yr below median (18 yr)
State licenses
3 states
Top 89% — 10% of peers are multi-state
Subspecialties
1
In the 32% of peers with subspecialties
NPI lifetime · 2012 → 2026
2012-05Enumerated in NPPES
2012
2026
Where they practice
Practice location
1255 Highway 54 W
Fayetteville, GA 302144526
Mailing address
5325 Faraon St
Saint Joseph, MO 645063488
Additional practice locations
1 secondary location on file with NPPES.
Location 2
5325 Faraon St
Saint Joseph, MO 64506
Specialties
-
Internal Medicine PrimaryA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
-
HospitalistHospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (KS) | 201125270A | |
| 01 (MO) | P01527145 | RR MEDICARE |
| 05 (MO) | 1821358003 | |
| 05 (IA) | 1821358003 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 138 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.