Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Koti R Mannem, MD

Individual provider Psychiatry Physician · NPI 1720188717

Dr. Koti R Mannem, MD is a Psychiatry in Green Bay, Wisconsin. Qualified in 1974, 52 years ago. Practices with County of Brown, a 16-clinician group and offers telehealth. Licensed in Wisconsin.

Years since qualifying
52
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3150 Gershwin Dr
Green Bay, WI 54311-5859
Phone: (920) 391-4700
Fax: (920) 391-4870
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 24001 (WI)

Record details

NPI number1720188717
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 22, 2006
Last updated in NPPESMarch 17, 2025
Certification dateMarch 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 1974 (52 years in practice)
Group practice County Of Brown — 16 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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