Mandeep K Mathaun, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

097648 Issued in GA

Practice address

400 Dawson Commons Cir Ste 410
Dawsonville, GA 30534-6269

Phone

(706) 344-1263

NPI assigned

Mar 2, 2020

Last updated

Mar 2, 2020By 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

State licenses

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1629602479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 IVY SUMMIT CT",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417136",
            "telephone_number": "330-999-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DAWSON COMMONS CIR STE 410",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346269",
            "telephone_number": "706-344-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHAUN",
        "first_name": "MANDEEP",
        "middle_name": "K",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "097648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Kevin Manderson
• Bilal Manzur, D.M.D.
• Rebecca Marrick, OTR/L
• Stephanie Marusarz
• Rhonda Gail Massey, CNM
• Brittany Hall Matson
• Christy Jill Matthews
• Michelle Anne Matthews, LPC
• Valerie Kaye Mattocks, FNP-BC, AGACNP-BC
• Tayler Mauldin

• Licensed Practical Nurse in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.