Brandi Nichole Mangrum, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

812 Issued in TN

Practice address

1776 Declaration Way
Thompsons Station, TN 37179-9674

Phone

(615) 417-9656

NPI assigned

Mar 9, 2007

Last updated

Jan 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514764800000",
    "number": "1467583492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 PALACE CT",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371799290",
            "telephone_number": "615-927-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 DECLARATION WAY",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371799674",
            "telephone_number": "615-417-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGRUM",
        "first_name": "BRANDI",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Thompsons Station, TN
• Providers in Thompsons Station, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2018; 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.