Jenna Rae Mangum

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3006 Lake Brook Blvd
Knoxville, TN 37909-1137

Phone

(865) 637-9711

NPI assigned

Jan 30, 2023

Last updated

May 31, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1770299000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 LAKE BROOK BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091137",
            "telephone_number": "865-637-9711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 Sutherland Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379192355",
            "country_code": "US",
            "telephone_number": "800-255-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "JENNA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Elizabeth Maner
• Pamela M Maness, CRNA
• Selina Mang
• Angelo Mangok
• Madison Mangrum, BCBA
• Amiee L Manis, OTR/L
• Gracie Christine Manis, PHARMD
• Jordan Manis, PHARMD.
• Mary M Manis
• Tami Manis, R.N.

• Counselor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.