Richard M Mangongo, SOCIAL WORK INTERN

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504

Phone

(210) 539-6150

NPI assigned

Jul 9, 2019

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1316599574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGONGO",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "SOCIAL WORK INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.m.mangongo2.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "encrypted email",
            "address_1": "3551 Roger Brooke Dr",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782344504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.m.mangongo2.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "encrypted email",
            "address_1": "3551 Roger Brooke Dr",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782344504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.m.mangongo2.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work email address-encrypted",
            "address_1": "3551 Roger Brooke Dr",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782344504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sunthosh Madireddi, M.D.
• Zachary Madlom, DO
• Todd Keith Magro, M.D.
• Pallavi Malladi, MD
• Jillian Perl Carraway Manalang, DO
• Joseph Marcus, MD
• Mildred H Marks, REGISTERED NURSE
• Sheila J Marquez, LCSW
• Rachel Lauren Martin, OD
• Tyler Alan Martin, MD

• Student in an Organized Health Care Education/Training Program in Jbsa Ft Sam Houston, TX
• Providers in Jbsa Ft Sam Houston, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.