Kimberlee May Manguiat-Lang

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

813967 Issued in NU

Practice address

420 Polifka Dr BLDG 1042
Shaw AFB, SC 29152-5100

Phone

(803) 895-1216

NPI assigned

Aug 31, 2006

Last updated

Aug 4, 2023By 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 2

Addresses

Other names 1

• Kimberlee May Manguiat-Lang Professional name

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1700997194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR BLDG 1042",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR BLDG 1042",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUIAT-LANG",
        "first_name": "KIMBERLEE",
        "middle_name": "MAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND4052",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "813967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEE",
            "last_name": "MANGUIAT-LANG",
            "middle_name": "MAY",
            "credential": "RD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ryan R Landoll, PH.D.
• Rhiannon Marie Leutner, PHARMD
• Jim Li
• Melissa Lincoln, PA-C
• Hanlon Ignatius Maivelett, PHARMD
• Desmond Jacob Marroquin
• Keasha Martin
• Gina G Mathews, LCSW-C
• Lauren Mattmuller, DMD
• Shanna Marie May, LISW-CP, LAC

• Registered Dietitian in Shaw AFB, SC
• Providers in Shaw AFB, SC by specialty
• Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.