Individual provider Active NPI

Donald Lance Mangum, D.C.

  • Chiropractor
  • Layton, UT
National Provider Identifier
1396889689
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
175753-1202 Issued in UT
Practice address
2112 N Hill Field Rd
Suite 2B
Layton, UT 84041-4047
Phone
(801) 774-0555
Fax
(801) 774-0588
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 175753-1202 UT Primary

Addresses

Primary practice location

2112 N Hill Field Rd
Suite 2B
Layton, UT 84041-4047

Mailing address

2112 N Hill Field Rd
Suite 2B
Layton, UT 84041-4047
Phone (801) 774-0555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000719 UT Practitioner - Chiropractic 2860579364 Practice locations: Beaver, UT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 942
Beaver, UT 84713-0942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L Smith DC Past Accepting new patients
Brad Young D.C., P.C. Chiropractor Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396889689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 N HILL FIELD RD",
            "address_2": "SUITE 2B",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414047",
            "telephone_number": "801-774-0555",
            "fax_number": "801-774-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 N HILL FIELD RD",
            "address_2": "SUITE 2B",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414047",
            "telephone_number": "801-774-0555",
            "fax_number": "801-774-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "DONALD",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "175753-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.