KAREN MANGUM (NPI# 1194264077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194264077 |
| Entity Type | Individual |
| Full Name | KAREN MANGUM |
| Credential | M.S., R.D.N., L.D. |
| Practice Address |
115 N. Main Street Suite #203 Boise ID 83702 |
| Mailing Address |
4726 W Clear Field Dr Eagle ID 83616-6957 |
| Practice Telephone | 2083818330 |
| Mailing Telephone | 2084405041 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | D-208 | ID | Dietary & Nutritional Service Providers |
| Street Address |
115 N. MAIN STREET SUITE #203 |
| City | BOISE |
| State | ID |
| Zip Code | 83702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| 1518311679 | Samantha Hersrud | Internal Medicine | 500 W Fort St 111r, Internal Medicine Residency, Boise, ID 83702 | 2016-04-14 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272965 | Katelyn Diane John | Dietitian, Registered | 967 N Clithero Dr, Boise, ID 83703-5703 | 2020-10-09 |
| 1245855113 | Megan Jensen | Dietitian, Registered | 6929 W Trail Dr, Boise, ID 83704-4568 | 2020-06-16 |
| 1437779469 | Nutrition Dejunked LLC | Dietitian, Registered | 3350 W Americana Ter Ste 215, Boise, ID 83706-2545 | 2020-04-20 |
| 1902445240 | Benjamin Von Lindern | Dietitian, Registered | 6333 N Buckley Pl, Boise, ID 83713-1204 | 2020-01-03 |
| 1215576095 | Lea Steiner | Dietitian, Registered | 500 W Fort St Stop 120, Boise, ID 83702-4501 | 2019-12-27 |
| 1508404880 | Morgan Alexis Pearson | Dietitian, Registered | 3301 W Camrose Ln, Boise, ID 83706-2712 | 2019-12-17 |
| 1720632433 | Jill Amber Leiser | Dietitian, Registered | 600 N Robbins Rd Ste 100, Boise, ID 83702-4564 | 2019-07-31 |
| 1790343127 | Carly Ruth Metcalf | Dietitian, Registered | 3562 S Tk Ave, Boise, ID 83705-5278 | 2019-05-31 |
| 1760049217 | Barbara Gordon | Dietitian, Registered | 2723 N Lakeharbor Ln, Boise, ID 83703-6240 | 2019-05-21 |
| 1538625827 | Boise Optimal Nutrition LLC | Dietitian, Registered | 6126 W State St Ste 206, Boise, ID 83703-2741 | 2019-02-12 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on KAREN MANGUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.