Active NPI
Maggie Mangrum
- Health & Wellness Coach
- Austin, TX
National Provider Identifier
1689243362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Practice address
- 2500 Aldford Dr
Austin, TX 78745-4822 - Phone
- (917) 628-4761
- NPI assigned
- Jun 17, 2021
- 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 |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | Primary |
Addresses
Primary practice location
2500 Aldford Dr
Austin, TX 78745-4822
Mailing address
75 Fountain St
Providence, RI 02902-0050
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virgin Pulse, Inc. | Current | Accepting new patients |
Locations
75 Fountain St
Providence, RI 02902
Phone (972) 677-1633
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 and National Provider Directory roles.
-
- Health Educator
- Providence, RI
- NPI 1538794771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623888000000",
"number": "1689243362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FOUNTAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029020050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 ALDFORD DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787454822",
"telephone_number": "917-628-4761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGRUM",
"first_name": "MAGGIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.