Individual provider Active NPI

Stephan Mangin

  • Massage Therapist
  • Austin, TX
National Provider Identifier
1780282798
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT129762 Issued in TX
Practice address
6605 Debcoe Dr
Austin, TX 78749-1784
Phone
(774) 270-0801
NPI assigned
Oct 12, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT129762 TX Primary

Addresses

Primary practice location

6605 Debcoe Dr
Austin, TX 78749-1784

Mailing address

6605 Debcoe Dr
Austin, TX 78749-1784
Phone (774) 270-0801

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

LicenseStateTypeSpecialty
MT129762TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1780282798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 DEBCOE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491784",
            "telephone_number": "774-270-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 DEBCOE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491784",
            "telephone_number": "774-270-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIN",
        "first_name": "STEPHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT129762",
            "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 Oct 12, 2020; 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.