MANGUM PRIMARY CARE LLC
NPI 1194494229
Clinic/Center - Primary Care in Boise, ID
About Mangum Primary Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MANGUM PRIMARY CARE LLC (NPI 1194494229) is a healthcare organization registered as a primary care in Boise, Idaho and active in the NPI registry since September 2021. The organization maintains a secondary practice location in Boise and lists Meredith Kaye Mangum, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mangum Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Mangum Primary Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mangum Primary Care LLC's NPI number?
The NPI number for Mangum Primary Care LLC is 1194494229. It was assigned to this organization in the NPPES registry on September 11, 2021.
Where is Mangum Primary Care LLC located?
Mangum Primary Care LLC is located at 3046 S Bown Way, Boise, ID 83706. The listed phone number is (801) 793-8124.
What is Mangum Primary Care LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Mangum Primary Care LLC enrolled in Medicare?
Yes. Mangum Primary Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mangum Primary Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mangum Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Mangum Primary Care LLC accept?
Health plans from Moda Health Plan, Inc. list Mangum Primary Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mangum Primary Care LLC was last updated on September 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mangum Primary Care Llc · NPI 1194494229
Primary Care organization in Boise, Idaho. Organization record, active in the CMS NPPES registry since September 11, 2021.
## Identity
- **NPI:** 1194494229 (Entity type: Organization)
- **Enumerated:** September 11, 2021
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Meredith Mangum, OWNER
## Practice location
- **Address:** 3046 S BOWN WAY, Boise, ID 83706-5499
- **Phone:** (801) 793-8124
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1194494229) · Data from the CMS NPPES public registry.