Active NPI
Kayleigh Mang, RD
- Registered Dietitian
- Lebanon, OR
National Provider Identifier
1487296968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 525 N Santiam Hwy
Lebanon, OR 97355-4363 - Phone
- (360) 258-2101
- NPI assigned
- Oct 16, 2019
- Last updated
- Oct 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | NU | Primary |
Addresses
Primary practice location
525 N Santiam Hwy
Lebanon, OR 97355-4363
Mailing address
1638 SE Crystal Lake Dr Apt C
Corvallis, OR 97333-1271
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571184000000",
"number": "1487296968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1638 SE CRYSTAL LAKE DR APT C",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973331271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N SANTIAM HWY",
"city": "LEBANON",
"state": "OR",
"postal_code": "973554363",
"telephone_number": "360-258-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANG",
"first_name": "KAYLEIGH",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-16",
"last_updated": "2019-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.