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MANCEL WAKHAM LLC
NPI 1487475067
Family Medicine in Kingston, TN

Active since October 17, 2024
1000 BRADFORD WAY STE 500, KINGSTON, TN 37763(865) 621-3601(865) 409-5733 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mancel Wakham Llc NPPES

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

MANCEL WAKHAM LLC (NPI 1487475067) is a healthcare organization registered as a family medicine in Kingston, Tennessee and active in the NPI registry since October 2024. The organization lists Mancel Wakhem, Owner, as its authorized official.

NPPES Registry Identity

NPI1487475067
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMANCEL WAKHAM LLC
Location Address1000 BRADFORD WAY STE 500Kingston, TN 37763-3126
Mailing Address1000 Bradford Way Ste 500Kingston, TN 37763-3126 · (865) 621-3601 · Fax (865) 409-5733
Phone(865) 621-3601
Fax(865) 409-5733
Organization SubpartNo
Authorized OfficialMancel WakhemOwner · (865) 621-3601
Enumeration DateOctober 17, 2024
NPPES CertifiedOctober 17, 2024
✔ NPI 1487475067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1000 BRADFORD WAY STE 500, Kingston, TN 37763
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.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)

Mancel Wakham Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Mancel Wakham LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Mancel Wakham, DO
Family Practice
NPI 1073568218
2497 S. ROANE ST. SUITE 110
Harriman, TN 37748
(865) 230-5698
✔ PECOS✔ Accepts Medicare5.7 mi
Amanda Collier
Nurse Practitioner
NPI 1669857850
129 HILLCREST DR
Byrdstown, TN 38549
(931) 864-3162
✔ PECOS✔ Accepts Medicare60 mi
Robert Ampudia, M.D.
General Surgery
NPI 1437127610
434 4TH ST STE 305
Newport, TN 37821
(423) 623-0419
✔ PECOS✔ Accepts Medicare75 mi
Catherine Smelley
Nurse Practitioner
NPI 1962087650
416 N SEMINARY ST
Florence, AL 35630
(256) 766-8667
✔ PECOS193 mi
Madelynn Henson
Nurse Practitioner
NPI 1669285599
102 PHYSICIANS DR STE C
Muscle Shoals, AL 35661
(256) 762-7011
✔ PECOS194 mi

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 Mancel Wakham LLC's NPI number?

The NPI number for Mancel Wakham LLC is 1487475067. It was assigned to this organization in the NPPES registry on October 17, 2024.

Where is Mancel Wakham LLC located?

Mancel Wakham LLC is located at 1000 Bradford Way Ste 500, Kingston, TN 37763. The listed phone number is (865) 621-3601.

What is Mancel Wakham LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mancel Wakham LLC enrolled in Medicare?

Yes. Mancel Wakham LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mancel Wakham LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Mancel Wakham 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. The largest specialties are Nurse Practitioner (3), Family Practice (1) and General Surgery (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mancel Wakham LLC accept?

Health plans from Cigna Healthcare list Mancel Wakham 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 Mancel Wakham LLC was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.