Individual provider Active NPI

Nora L. Mangham, LPN

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1174877609
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
095397 Issued in OH
Practice address
748 Ridgeway Ave
Cincinnati, OH 45229-3227
Phone
(937) 559-5410
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 095397 OH Primary

Addresses

Primary practice location

748 Ridgeway Ave
Cincinnati, OH 45229-3227

Mailing address

748 Ridgeway Ave
Cincinnati, OH 45229-3227
Phone (937) 559-5410

Other identifiers 1

IdentifierTypeStateIssuer
095397OtherOHOHIO BOARD OF NUSING

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

LicenseStateTypeSpecialty
095397OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1174877609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 RIDGEWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293227",
            "telephone_number": "937-559-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 RIDGEWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293227",
            "telephone_number": "937-559-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGHAM",
        "first_name": "NORA",
        "middle_name": "L.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "095397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF NUSING",
            "identifier": "095397",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.