MRS. MARIAM MANGU NANTANG PMHNP
NPI 1003635087
Nurse Practitioner - Psychiatric/Mental Health in Greensboro, NC

Q: What is Mariam Nantang's NPI number?

The NPI number for Mariam Nantang is 1003635087. It was assigned to this individual provider in the NPPES registry on October 7, 2024.

Q: What is Mariam Nantang's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Mariam Nantang was last updated on January 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 07, 2024PECOS Enrolled

717 GREEN VALLEY RD STE 200, GREENSBORO, NC 27408(743) 222-9755 Get Directions Write a Review

NPPES record last updated: January 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mrs. Mariam Mangu Nantang Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARIAM MANGU NANTANG PMHNP (NPI 1003635087) is an individual psychiatric/mental health provider in Greensboro, North Carolina, licensed in North Carolina (245103) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cary, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1003635087

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMRS. MARIAM MANGU NANTANGCredential: PMHNP

Location Address717 GREEN VALLEY RD STE 200Greensboro, NC 27408-2156

Mailing Address717 Green Valley Rd Ste 200Greensboro, NC 27408-2156 · (743) 222-9755

Phone(743) 222-9755

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateOctober 7, 2024

Last NPPES UpdateJanuary 17, 2025

NPPES CertifiedJanuary 17, 2025

✔ NPI 1003635087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NC · 245103

717 GREEN VALLEY RD STE 200, Greensboro, NC 27408

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Secondary Practice Location 1

Location 11140 Kildaire Farm Rd Rm 12Cary, NC 27511-4562 · Phone (743) 222-9755

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mariam Mangu Nantang Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416462619

PECOS Enrollment IDI20250904001637

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27408 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNA RENFROE PHD

Clinical Neuropsychologist