MR. KEVIN DEE MANGUM I (NPI# 1417174392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417174392 |
| Entity Type | Individual |
| Full Name | MR. KEVIN DEE MANGUM I |
| Credential | ATC LAT |
| Practice Address |
5800 Airline Dr Metairie LA 70003-3876 |
| Mailing Address |
5325 Cocos Plumosas Dr Kenner LA 70065-2320 |
| Practice Telephone | 5047330255 |
| Practice Fax Number | 5047311805 |
| Mailing Telephone | 5048859111 |
| Mailing Fax Number | 5047311805 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
ATH.J00034 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295399186 | Kevin Dale Mangum | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive Spc 5856, Fcvc 3rd Floor, Reception B, Ann Arbor, MI 48109-5856 | 2019-04-25 |
| 1609140847 | Kevin Mangum | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2012-03-06 |
| Street Address |
5800 AIRLINE DR |
| City | METAIRIE |
| State | LA |
| Zip Code | 70003-3876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417358441 | Benedict William Stollberg | Specialist/Technologist | 5800 Airline Dr, Metairie, LA 70003-3876 | 2014-09-09 |
| 1396153979 | Patrick Flynn Driscoll | Specialist/Technologist | 5800 Airline Dr, Metairie, LA 70003-3876 | 2014-07-28 |
| 1508280314 | Duane Brooks | Specialist/Technologist | 5800 Airline Dr, Metairie, LA 70003-3876 | 2014-02-13 |
| 1336563246 | Reggie Stone | Specialist/Technologist | 5800 Airline Dr, Metairie, LA 70003-3876 | 2014-02-12 |
| 1164846069 | Scottie Patton | Specialist/Technologist | 5800 Airline Dr, Metairie, LA 70003-3876 | 2014-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154816536 | Southshore Speech Therapy | Speech-Language Pathologist | 2009 Riviere Ave, Metairie, LA 70003 | 2018-06-27 |
| 1871005504 | Theresa Ward | Case Manager/Care Coordinator | 7813 Airline Dr Ste B, Metairie, LA 70003 | 2017-11-03 |
| 1205350360 | Alishia Quinn | Counselor | 7809 Airline Highway Ste. 211-d, Metairie, LA 70003 | 2017-07-31 |
| 1306392071 | Brittany Poirrier | Pharmacist | 5300 Veterans Blvd, Metairie, LA 70003 | 2016-08-31 |
| 1326591793 | Alphacare Support | Day Training, Developmentally Disabled Services | 7809 Airline Dr., Ste. 210, Metairie, LA 70003 | 2016-08-02 |
| 1386014678 | Elite Behavioral Health Service, LLC | Counselor | 7809 Airline Drive, Suite 304c, Metairie, LA 70003 | 2015-09-30 |
| 1255709515 | Ha Huynh | Pharmacist | 7127 Veterans Memorial Blvd, Metairie, LA 70003 | 2015-09-03 |
| 1467843227 | Jennifer Meganm Anderson | Behavioral Analyst | 3233 Lisa Drive, Metairie, LA 70003 | 2015-02-13 |
| 1619379674 | Seth Jude Delise | Pharmacist | 2940 Veterans Blvd, Metairie, LA 70003 | 2014-09-22 |
| 1811397656 | Walmart Pharmacy | Pharmacist | 8912 Veterans Blvd, Metairie, LA 70003 | 2014-08-29 |
| Find all providers in zip 70003 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962847 | Alexa Yanez | Specialist/Technologist | 936 Elmeer Ave, Metairie, LA 70005-1612 | 2020-08-11 |
| 1013473370 | Carly Templet | Specialist/Technologist | 3971 Pharr St, Metairie, LA 70002-4361 | 2019-02-12 |
| 1295299626 | Sarah Guilbeau | Specialist/Technologist | 8800 Veterans Memorial Blvd, Metairie, LA 70003-5235 | 2019-01-30 |
| 1528550894 | Alyssa Spina | Specialist/Technologist | 1413 Colony Pl, Metairie, LA 70003-2343 | 2018-06-03 |
| 1679026280 | Bethany Perez | Specialist/Technologist | 3621 Taft Park, Metairie, LA 70002-4559 | 2016-07-31 |
| 1841663184 | Bayley Romig | Specialist/Technologist | 1417 Hackberry Ave, Metairie, LA 70001-3315 | 2015-11-09 |
| 1457724783 | David Gambel | Specialist/Technologist | 4901 Green Acres Ct, Metairie, LA 70003-1107 | 2015-11-09 |
| 1427336460 | Loren Aleman | Specialist/Technologist | 827 Kent Ave, Metairie, LA 70001-4331 | 2011-07-25 |
| 1184921231 | Katherine Corbly Miller | Specialist/Technologist | 300 Park Rd, Metairie, LA 70005-4142 | 2011-02-24 |
| 1033267505 | Raymond Raphael | Specialist/Technologist | 617 Aris Ave, Metairie, LA 70005-2927 | 2007-01-08 |
| Find all providers in METAIRIE | ||||
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| 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.