Active NPI
Mahantie Thomas, LVN
- Licensed Vocational Nurse
- San Diego, CA
National Provider Identifier
1962708180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 211262
- Practice address
- 2851 Meadow Lark Dr
San Diego, CA 92123-2709 - Phone
- (858) 571-1964
- Fax
- (858) 571-1967
- NPI assigned
- Feb 4, 2011
- 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 211262 | CA | Primary |
Addresses
Primary practice location
2851 Meadow Lark Dr
San Diego, CA 92123-2709
Mailing address
483 Dennery Rd
Apt 78
San Diego, CA 92154-8533
Phone (858) 397-3137
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
| License | State | Type | Specialty |
|---|---|---|---|
| 211262 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434326400000",
"number": "1962708180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "483 DENNERY RD",
"address_2": "APT 78",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921548533",
"telephone_number": "858-397-3137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2851 MEADOW LARK DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232709",
"telephone_number": "858-571-1964",
"fax_number": "858-571-1967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "MAHANTIE",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-04",
"last_updated": "2015-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "211262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.