KEVIN MANGUM D.O.
NPI 1609140847
Family Medicine - Sports Medicine in Murray, UT

Q: What is Kevin Mangum's NPI number?

The NPI number for Kevin Mangum is 1609140847. It was assigned to this individual provider in the NPPES registry on March 6, 2012.

Q: What is Kevin Mangum's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Mangum was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 March 06, 2012PECOS EnrolledAccepts Medicare Assignment

95.7/100

CMS Quality Rating

6095 S FASHION BLVD STE 220, MURRAY, UT 84107(801) 758-8735(801) 769-2092 Get Directions Write a Review

NPPES record last updated: June 19, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 19, 2023, Apr 4, 2023, Dec 12, 2022 and 6 more (9 updates tracked since 2017).

On this page

About Kevin Mangum D.o. NPPES

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

KEVIN MANGUM D.O. (NPI 1609140847) is an individual sports medicine provider in Murray, Utah, licensed in Utah (8164477-1204) and active in the NPI registry since March 2012. He is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa (2017).

NPPES Registry Identity

NPI1609140847

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameKEVIN MANGUMCredential: D.O.

Location Address6095 S FASHION BLVD STE 220Murray, UT 84107-7393

Mailing Address6095 S Fashion Blvd Ste 220Murray, UT 84107-7393 · (801) 758-8735 · Fax (801) 769-2092

Phone(801) 758-8735

Fax(801) 769-2092

Sole ProprietorNo

Medical School CMSAt Still Un Of Hlth Sciences, Col Of Osteo Med, MesaGraduated 2017

Enumeration DateMarch 6, 2012

Last NPPES UpdateJune 19, 20239 updates tracked since enumeration

NPPES CertifiedJune 19, 2023

✔ NPI 1609140847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in UT · 8164477-1204

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 8164477-1204 (UT)

6095 S FASHION BLVD STE 220, Murray, UT 84107

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Mangum D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961825641

PECOS Enrollment IDI20210813003052

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.

Medicare Billing Reassignments

Medicare enrollment records show Kevin Mangum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Primary Healthcare, PLLC

Same address

Primary Care

6095 S FASHION BLVD STE 220
Murray, UT 84107

Reassigned Medicare billing, Utah enrollment
3 clinicians in this Medicare group

NPI 1700503182 (801) 758-8735

University Of Utah Community Physicians Group

1.6 mi

Family Medicine

7495 S STATE ST
Midvale, UT 84047

Reassigned Medicare billing, Utah enrollment
295 clinicians in this Medicare group

NPI 1528462231 (801) 213-9400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

249 services87 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

68 services14 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

49 services49 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

38 services28 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

33 services19 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

30 services28 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number460009

Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County

Emergency services Birthing friendly

Intermountain Medical Center

Acute Care Hospitals · Murray, UT

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460010

Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County

Emergency services Birthing friendly

Intermountain Health Alta View Hospital

Acute Care Hospitals · Sandy, UT

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460044

Location9660 South 1300 EastSandy, UT 84094 · Salt Lake County

Emergency services Birthing friendly

St Mark's Hospital

Acute Care Hospitals · Salt Lake City, UT

3/5 CMS rating

OwnershipProprietary

CMS Certification Number460047

Location1200 East 3900 SouthSalt Lake City, UT 84124 · Salt Lake County

Emergency services Birthing friendly

Lone Peak Hospital

Acute Care Hospitals · Draper, UT

5/5 CMS rating

OwnershipProprietary

CMS Certification Number460060

Location11925 South State StreetDraper, UT 84020 · Salt Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.7/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

92.19

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 4

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

ROSILEE W BARKER PA C

Physician Assistant

6095 S FASHION BLVD STE 220
MURRAY, UT 84107

Salt Lake County (801) 758-8735

DENTISTRY FOR CHILDREN LLC

Dentist (Pediatric Dentistry)

6095 S FASHION BLVD STE 220
MURRAY, UT 84107

Salt Lake County (801) 268-4986

PRIMARY HEALTHCARE, PLLC

Clinic/Center (Primary Care)

6095 S FASHION BLVD STE 220
MURRAY, UT 84107

Salt Lake County (801) 758-8735

WHITNEY CORINNE JOHN APRN

Nurse Practitioner (Family)

6095 S FASHION BLVD STE 220
MURRAY, UT 84107

Salt Lake County (801) 758-8735

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 Kevin Mangum's NPI number?

The NPI number for Kevin Mangum is 1609140847. It was assigned to this individual provider in the NPPES registry on March 6, 2012.

Where is Kevin Mangum located?

Kevin Mangum practices at 6095 S Fashion Blvd Ste 220, Murray, UT 84107. The listed phone number is (801) 758-8735.

What is Kevin Mangum's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Kevin Mangum enrolled in Medicare?

Yes. Kevin Mangum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kevin Mangum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Mangum reassigns Medicare benefits to 2 organizations: Primary Healthcare, PLLC (Murray, UT) and University Of Utah Community Physicians Group (Midvale, UT). Each 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 Kevin Mangum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Mangum accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Kevin Mangum 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.

Is Kevin Mangum affiliated with any hospitals?

According to CMS data, Kevin Mangum is affiliated with University Of Utah Hospitals And Clinics, Intermountain Medical Center, Intermountain Health Alta View Hospital, St Mark's Hospital and Lone Peak Hospital.

When was this NPI record last updated?

The NPPES record for Kevin Mangum was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.