Individual provider Active NPI

Berrylin Ray Martin Mangin, PSY.D.

  • Clinical Psychologist
  • Nashville, TN
National Provider Identifier
1306254586
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2881 Issued in TN
Practice address
2021 Richard Jones Rd
Suite 350B
Nashville, TN 37215-2860
Phone
(615) 707-2437
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2881 TN Primary

Addresses

Primary practice location

2021 Richard Jones Rd
Suite 350B
Nashville, TN 37215-2860

Mailing address

2021 Richard Jones Rd
Suite 350B
Nashville, TN 37215-2860
Phone (615) 707-2437

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1306254586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 RICHARD JONES RD",
            "address_2": "SUITE 350B",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152860",
            "telephone_number": "615-707-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 RICHARD JONES RD",
            "address_2": "SUITE 350B",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152860",
            "telephone_number": "615-707-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIN",
        "first_name": "BERRYLIN",
        "middle_name": "RAY MARTIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.