Organization Active NPI

Mango Medical DPC

  • Primary Care Clinic/Center
  • Hampton, VA
National Provider Identifier
1548029580
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MANGO MEDICAL DPC
Practice address
23 S Mallory St Ste C
Hampton, VA 23663-1707
Phone
(757) 210-5959
Fax
(800) 313-5613
NPI assigned
Mar 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Nzinga Teule-Hekima, MDNPI 1851399901
Title
MD/Ceo
Phone
(757) 210-5959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

23 S Mallory St Ste C
Hampton, VA 23663-1707

Mailing address

23 S Mallory St Ste B
Hampton, VA 23663-1707
Phone (757) 210-5959

National Provider Directory

National Provider Directory

Locations

23 S Mallory St
#B
Hampton, VA 23663

23 S Mallory St
#C
Hampton, VA 23663
Phone (757) 210-5959

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1548029580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 S MALLORY ST STE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236631707",
            "telephone_number": "757-210-5959",
            "fax_number": "800-313-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S MALLORY ST STE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236631707",
            "telephone_number": "757-210-5959",
            "fax_number": "800-313-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGO MEDICAL DPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "TEULE-HEKIMA",
        "authorized_official_first_name": "NZINGA",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "757-210-5959",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.