Individual provider Active NPI

Brittany Liu Mangham, FNP

  • Family Nurse Practitioner
  • Georgetown, TX
National Provider Identifier
1609509967
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1059609 Issued in TX
Practice address
103 Thousand Oaks Blvd
Georgetown, TX 78628-8757
Phone
(512) 733-5800
NPI assigned
Jul 5, 2022
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1059609 TX Primary

Addresses

Primary practice location

103 Thousand Oaks Blvd
Georgetown, TX 78628-8757

Mailing address

101 Kleingrass CT
Bertram, TX 78605-2201
Phone (903) 746-8767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260430000447 TX Practitioner - Nurse Practitioner 1153898804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trinity Balanced Family Healthcare LLCGroup PAC ID 3476095753, 4 clinicians

Practice addresses (Care Compare)

103 Thousand Oaks Blvd
Georgetown, TX 78628-8757
Phone (512) 733-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1059609TXMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1609509967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KLEINGRASS CT",
            "city": "BERTRAM",
            "state": "TX",
            "postal_code": "786052201",
            "telephone_number": "903-746-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 THOUSAND OAKS BLVD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288757",
            "telephone_number": "512-733-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGHAM",
        "first_name": "BRITTANY",
        "middle_name": "LIU",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1059609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.