Reginald Mungrue

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL3036 Issued in FL

Practice address

111 Lake Hollingsworth Dr
Lakeland, FL 33801-5698

Phone

(863) 680-4267

NPI assigned

Sep 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1962018077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7357 GUNSTOCK DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338096616",
            "telephone_number": "863-712-0261",
            "fax_number": "863-680-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAKE HOLLINGSWORTH DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015698",
            "telephone_number": "863-680-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNGRUE",
        "first_name": "REGINALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Lakeland",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 Lake Hollingsworth Dr",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338015698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Munday Chiropractic Clinic P a
• Charles A. Munday, D.C.
• Kristina N. Munday, D.C.
• Linda Blevins Munday, ARNP
• Kenneth Lawrence Mundy, DDS
• Jorge Alberto Munoz
• Vanessa Munoz
• Magda Patricia Murillo, RMHCI
• Nichole Whidden Murphy, APRN
• Karmiec Murray

• Athletic Trainer in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.