DEBORAH MANGHAM (NPI# 1275519563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275519563 |
| Entity Type | Individual |
| Full Name | DEBORAH MANGHAM |
| Practice Address |
3525 Monterey Dr St Louis Park MN 55416-5275 |
| Mailing Address |
3800 Park Nicollet Blvd Credentialing St Louis Park MN 55416-2527 |
| Practice Telephone | 9529936200 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2012-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25696 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
3525 MONTEREY DR |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-5275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440371 | Samantha Marie Slinger | Occupational Therapist | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2020-02-26 |
| 1528603412 | Kelli Lynn Jones | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-11-14 |
| 1558919068 | Lucy Ramquist | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-08-28 |
| 1174170146 | Miranda Larson | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-08-23 |
| 1467014043 | Kendra Rose Johnson | Occupational Therapist | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-07-03 |
| 1669952180 | Hannah Paruzynski | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416 | 2018-08-14 |
| 1881114056 | Kaitlin Lezcano Lytle | Counselor | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2017-06-20 |
| 1497283253 | John Leland Mckinley | Nurse Practitioner | 3525 Monterey Dr, St Louis Park, MN 55416 | 2017-05-24 |
| 1417483744 | Kayla Joy Muckenhirn | Occupational Therapist | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2017-05-05 |
| 1285170357 | Benjamin Hamilton Meyers | Counselor | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2017-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225065279 | Kristin Kay Christiansen | Family Medicine | 6600 Excelsior Blvd Ste 181, St Louis Park, MN 55426-4747 | 2006-06-26 |
| 1720040900 | Himanshu S Sharma | Family Medicine | 6600 Excelsior Blvd Ste 160, St Louis Park, MN 55426-4713 | 2006-04-04 |
| 1174500995 | Thomas A Schmidt | Family Medicine | Methodist Hospital Administration, 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2005-12-22 |
| 1043295587 | Michael Dukinfield | Family Medicine | 6600 Excelsior Blvd, Suite 160, St Louis Park, MN 55426-4744 | 2005-12-07 |
| 1669471900 | Michael A Dole | Family Medicine | 3408 Dakota Ave S, St Louis Park, MN 55416-2312 | 2005-07-19 |
| 1386135622 | Jessica Jane Miller | Family Medicine | 6600 Excelsior Blvd Ste 160, St Louis Park, MN 55426-4713 | 2018-05-22 |
| 1295180628 | Isaac Zoller | Family Medicine | 6600 Excelsior Blvd Ste 160, St Louis Park, MN 55426-4713 | 2016-05-04 |
| 1609259688 | Maria Teresa Gonzalez Bolanos | Family Medicine | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2015-07-08 |
| 1538540109 | Elina Lipovskiy | Family Medicine | 3850 Park Nicollet Blvd, St Louis Park, MN 55416 | 2015-06-09 |
| 1952788291 | Judith Rose Boylan | Family Medicine | 6600 Excelsior Blvd Ste 160, St Louis Park, MN 55426-4713 | 2015-05-06 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
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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.