MANGUM PRIMARY CARE LLC
NPI 1194494229
Clinic/Center - Primary Care in Boise, ID

Active since September 11, 2021
3046 S BOWN WAY, BOISE, ID 83706(801) 793-8124 Get Directions Write a Review

NPPES record last updated: September 11, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1194494229
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMANGUM PRIMARY CARE LLC
Location Address3046 S BOWN WAYBoise, ID 83706-5499
Mailing Address608 S Phillippi StBoise, ID 83705-1160 · (801) 793-8124
Organization SubpartNo
Authorized OfficialMeredith Kaye MangumOwner · (801) 793-8124
Enumeration DateSeptember 11, 2021
NPPES CertifiedSeptember 11, 2021
NPI 1194494229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
3046 S BOWN WAY, Boise, ID 83706

Secondary Practice Location 1

Location 13050 N Lakeharbor Ln Ste 120Boise, ID 83703-6917 · Phone (208) 550-3456

Accepted Insurance

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Family)
3046 S BOWN WAY
BOISE, ID 83706

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.

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 with the weekly NPPES data releases published by CMS.