Thomas Bennett Mahan II, RRT

Primary specialty

Critical Care Registered Respiratory TherapistTaxonomy code 2279C0205X

License

RT12051 Issued in FL

Practice address

619 S Marion Ave
Lake City, FL 32025-5808

Phone

(386) 719-2851

NPI assigned

Feb 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1194470385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7589 SE COUNTY ROAD 232",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326934739",
            "telephone_number": "352-221-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-719-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "THOMAS",
        "middle_name": "BENNETT",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "FL",
            "license": "RT12051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Adult
• Magnolia Adult
• Magnolia Family Care Corp
• Magnolia Pediatrics LLC
• Cynthia Bautista Magrini, MD
• Heather Marie Mahoney, LCSW
• Lauren Maloney, MSCAP
• Patrick Maltba
• Emmalee Diane Manning
• Jackie Renee Manning, ARNP

• Critical Care Registered Respiratory Therapist in Lake City, FL
• Providers in Lake City, FL by specialty
• Critical Care Registered Respiratory Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.