Active NPI
Heather P Mammen, D.C.
- Chiropractor
- Louisville, KY
National Provider Identifier
1700900628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4665
- Practice address
- 6817 Sandstone Blvd
Louisville, KY 40219 - Phone
- (502) 689-3335
- NPI assigned
- Mar 17, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4665 | KY | Primary |
Addresses
Primary practice location
6817 Sandstone Blvd
Louisville, KY 40219
Mailing address
6917 Sandstone Blvd
Louisville, KY 40219
Phone (502) 689-3335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85002608 | Medicaid | KY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4665 | KY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427328000000",
"number": "1700900628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6917 SANDSTONE BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40219",
"telephone_number": "502-689-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6817 SANDSTONE BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40219",
"telephone_number": "502-689-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMMEN",
"first_name": "HEATHER",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-17",
"last_updated": "2015-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "4665",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85002608",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.