Active NPI
Antoinette Mangum
- Case Manager/Care Coordinator
- North Hills, CA
National Provider Identifier
1124543293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 15305 Rayen St
North Hills, CA 91343-5117 - Phone
- (818) 892-3423
- NPI assigned
- Aug 9, 2017
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
15305 Rayen St
North Hills, CA 91343-5117
Mailing address
15305 Rayen St
North Hills, CA 91343-5117
Phone (818) 892-3423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95-2633765 | Other | CA | MEDI-CAL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1124543293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15305 RAYEN ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913435117",
"telephone_number": "818-892-3423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15305 RAYEN ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913435117",
"telephone_number": "818-892-3423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUM",
"first_name": "ANTOINETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-09",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "95-2633765",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.