Active NPI
Amber Lynne Mangum, RBT
- Behavior Technician
- Pinellas Park, FL
National Provider Identifier
1053003756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-274737
- Practice address
- 5100 78TH Ave N Ste 6
Pinellas Park, FL 33781-2407 - Phone
- (727) 289-9626
- NPI assigned
- May 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-274737 | FL | Primary |
Addresses
Primary practice location
5100 78TH Ave N Ste 6
Pinellas Park, FL 33781-2407
Mailing address
246 22ND Ave SE
Saint Petersburg, FL 33705-2831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-274737 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1053003756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "246 22ND AVE SE",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337052831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 78TH AVE N STE 6",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337812407",
"telephone_number": "727-289-9626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUM",
"first_name": "AMBER",
"middle_name": "LYNNE",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-23-274737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinellas Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.