Brendon Davis Mann

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4927 Issued in NC

Practice address

409 S Oakland St
Gastonia, NC 28052-4312

Phone

(704) 874-9005

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmann295893@direct.ochin.org

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.

• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215
  Medicare reassignment NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1447320809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE STE 300",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1936",
            "fax_number": "704-864-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 S OAKLAND ST",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524312",
            "telephone_number": "704-874-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1985 Tate Blvd SE",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "28602",
            "country_code": "US",
            "telephone_number": "828-326-5960",
            "fax_number": "828-328-4729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "BRENDON",
        "middle_name": "DAVIS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "4927",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4927",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102757",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirsten Mancogna
• Ranadeep Reddy Mandhadi, MD
• Haley Jackson Mangiafesto, MS, LMHC, LCMHC
• Melissa Mangum, SLP
• Manish V Sheladia DMD
• Stefanie Renee Mann, LCMHC
• Melissa Ann Manners, CRNA
• Gregory Allen Mantooth, M.D.
• Imiah Mapp
• Sierra Margarita

• Mental Health Counselor in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.