Courageous Coaching Mt LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

COURAGEOUS COACHING MT LLC

Practice address

4385 Corley St
Beaumont, TX 77707-4433

Phone

(409) 235-1400

Fax

(877) 920-1977

NPI assigned

Jan 22, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mignon Thomas, LVN

Title

Ceo/Owner

Phone

(409) 679-9338

Specialties & licenses 2

Addresses

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642809600000",
    "number": "1023760808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 CORLEY ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777074433",
            "telephone_number": "409-235-1400",
            "fax_number": "877-920-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4385 CORLEY ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777074433",
            "telephone_number": "409-235-1400",
            "fax_number": "877-920-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGEOUS COACHING MT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-22",
        "last_updated": "2022-01-22",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MIGNON",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "409-679-9338",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mignon@courageousmt.com",
            "affiliation": "N",
            "endpointDescription": "Corporate  email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4385 Corley St",
            "city": "Beaumont",
            "state": "TX",
            "country_code": "US",
            "postal_code": "777074433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Beaumont, TX
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.