SHANE C MANGRUM M.D.
NPI 1891796595
Physical Medicine & Rehabilitation - Pain Medicine in Atlanta, GA
NPI Status: Active since August 03, 2005
Contact Information
1150 HAMMOND DR
SUITE 400
ATLANTA, GA
ZIP 30328
Phone: (404) 256-2633
Fax: (404) 255-6532
- Individual
- Male
- Physical Medicine & Rehabilitation
- Pain Medicine
- PECOS Enrolled
- Opted-Out Medicare
About SHANE MANGRUM
This page provides the complete NPI Profile along with additional information for Shane Mangrum, a provider established in Atlanta, Georgia with a medical specialization in Physical Medicine & Rehabilitation, focusing in pain medicine . The healthcare provider is registered in the NPI registry with number 1891796595 assigned on August 2005. The practitioner's primary taxonomy code is 2081P2900X with license number 73026 (GA). The provider is registered as an individual and his NPI record was last updated February 2026.
- NPI
- 1891796595
- Provider Name
- SHANE C MANGRUM M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1150 HAMMOND DR SUITE 400 ATLANTA, GA 30328
- Location Phone
- (404) 256-2633
- Location Fax
- (404) 255-6532
- Mailing Address
- 1150 HAMMOND DR SUITE 400 ATLANTA, GA 30328
- Mailing Phone
- (404) 256-2633
- Mailing Fax
- (404) 255-6532
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-03-2005
- Last Update Date
- 02-12-2026
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Shane Mangrum opted out of Medicare effective on 07-01-2017 until 07-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Medicine & Rehabilitation Pain Medicine
- Taxonomy Code
- 2081P2900X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 73026
- License State
- GA
- Taxonomy Description
- A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | M9189 (ID) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 807178100 | MEDICAID (05) | ID |
Medicare Participation & PECOS Enrollment Status
Shane Mangrum is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-01-2017
Opt-Out End Date: 07-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1891796595, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 75 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
ATLANTA, GA 30328
ATLANTA, GA 30328
ATLANTA, GA 30328
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891796595, enumerated as an "individual" on August 03, 2005.
The provider is located at 1150 HAMMOND DR SUITE 400 ATLANTA, GA 30328 and the phone number is (404) 256-2633.
Physical Medicine & Rehabilitation with taxonomy code 2081P2900X and a focus in Pain Medicine.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
