Jared D Mangum, DC, MBA, LMT

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-2025 Issued in ID

Practice address

8659 N Rude St
Hayden, ID 83835-8255

Phone

(801) 762-7447

NPI assigned

Apr 18, 2012

Last updated

Jul 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1578820247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8659 N RUDE ST",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358255",
            "telephone_number": "801-762-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8659 N RUDE ST",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358255",
            "telephone_number": "801-762-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "JARED",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC, MBA, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5266084-1202",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke B Lunsford, LCSW
• Elizabeth Lynn
• Mary Jo Jo Lyons, RPH
• Sheila M Mack
• Aria Mangan
• Gillian D. Maples, FNP
• Nichole Ashley Marleau, DPT
• Kevin Robert Marsh, D.C.
• Julianne Matteson, PT
• Richard Joseph May, DC

• Chiropractor in Hayden, ID
• Providers in Hayden, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.