Marilyn Kay Mangelos, R.N.

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN258880 Issued in CA

Practice address

838 Cobblestone CT
Ripon, CA 95366-2656

Phone

(209) 599-4917

Fax

(209) 599-9275

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407975196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 COBBLESTONE CT",
            "city": "RIPON",
            "state": "CA",
            "postal_code": "953662656",
            "telephone_number": "209-599-4917",
            "fax_number": "209-599-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 COBBLESTONE CT",
            "city": "RIPON",
            "state": "CA",
            "postal_code": "953662656",
            "telephone_number": "209-599-4917",
            "fax_number": "209-599-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGELOS",
        "first_name": "MARILYN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "RN258880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "EPS005060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron D Long, PA
• Longs Drug Stores California LLC
• Melissa Lopez, MEDICAL MT
• Sylvia Lopez
• Tiffany Lutz
• Frank Martinez, MA, PPS
• Gina Marie McCay, FNP
• Marshall Allan Meyer
• Noelle Meyer
• Saray Montoya Mora, PT, DPT

• All providers in Ripon, CA
• Home Health Registered Nurse in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.