Active NPI
Tammy Rebecca Mandigo
- Child Physical Disabilities Respite Care
- South Hero, VT
National Provider Identifier
1669784302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Physical Disabilities Respite Care
- License
- 025.0008399
- Practice address
- 38 Whipple Rd
South Hero, VT 05486-4900 - Phone
- (802) 732-4020
- NPI assigned
- Jul 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Child Physical Disabilities Respite Care | 385HR2065X | 025.0008399 | VT | Primary |
Addresses
Primary practice location
38 Whipple Rd
South Hero, VT 05486-4900
Mailing address
254 Heath Road
Tammy Mandigo
South Hero, VT 05486-4900
Phone (802) 730-8095
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025.0008399 | VT | MD | Child Physical Disabilities Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278720000000",
"number": "1669784302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 HEATH ROAD",
"address_2": "TAMMY MANDIGO",
"city": "SOUTH HERO",
"state": "VT",
"postal_code": "054864900",
"telephone_number": "802-730-8095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 WHIPPLE RD",
"city": "SOUTH HERO",
"state": "VT",
"postal_code": "054864900",
"telephone_number": "802-732-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDIGO",
"first_name": "TAMMY",
"middle_name": "REBECCA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-10",
"last_updated": "2010-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": "VT",
"license": "025.0008399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hero, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.