MR. CARL H MANGUM PHD, NP, RN
NPI 1447647946
Nurse Practitioner - Psychiatric/Mental Health in Jackson, MS

Q: What is Carl Mangum's NPI number?

The NPI number for Carl Mangum is 1447647946. It was assigned to this individual provider in the NPPES registry on April 22, 2015.

Q: What is Carl Mangum'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 Carl Mangum was last updated on June 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since April 22, 2015PECOS Enrolled

2500 N STATE ST, JACKSON, MS 39216(601) 815-4128 Get Directions Write a Review

NPPES record last updated: June 3, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Carl H Mangum Phd, Np, Rn NPPES

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

MR. CARL H MANGUM PHD, NP, RN (NPI 1447647946) is an individual psychiatric/mental health provider in Jackson, Mississippi, licensed in Mississippi (2012015018) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447647946

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. CARL H MANGUMCredential: PHD, NP, RN

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address2500 N State StJackson, MS 39216-4500 · (601) 815-4128

Phone(601) 815-4128

Sole ProprietorNo

Enumeration DateApril 22, 2015

Last NPPES UpdateJune 3, 2015

✔ NPI 1447647946 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 MS · 2012015018

2500 N STATE ST, Jackson, MS 39216

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Other Identifiers 1

Medicare PIN412731YS8TMS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Carl H Mangum Phd, Np, Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 39216 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)