Individual provider Active NPI

Beth Wangombe

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1457724502
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP129603 Issued in TX
Practice address
2384 Highway 287 N Ste 206
Mansfield, TX 76063-9207
Phone
(682) 518-3334
NPI assigned
Nov 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP129603 TX Primary

Addresses

Primary practice location

2384 Highway 287 N Ste 206
Mansfield, TX 76063-9207

Mailing address

1380 River Bend Dr
Dallas, TX 75247-4914
Phone (214) 743-6146

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
In Touch Psychiatry Consultants & Family Medicine, PLLC CurrentSince Jan 15, 2019 Accepting new patients

Locations

1024 E Broad St
Ste 207
Mansfield, TX 76063
Phone (682) 503-1422

Organizations & group practices 1

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": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1457724502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474914",
            "telephone_number": "214-743-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 HIGHWAY 287 N STE 206",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639207",
            "telephone_number": "682-518-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGOMBE",
        "first_name": "BETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP129603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.