ANDREW REYNOLDS MANGAN
NPI 1922858802
Student in an Organized Health Care Education/Training Program in Little Rock, AR

Active since March 25, 2024PECOS Enrolled
4301 W MARKHAM ST # 543, LITTLE ROCK, AR 72205(501) 603-1214 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Andrew Reynolds Mangan NPPES

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

ANDREW REYNOLDS MANGAN (NPI 1922858802) is an individual student in an organized health care education/training program in Little Rock, Arkansas and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Little Rock.

NPPES Registry Identity

NPI1922858802
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDREW REYNOLDS MANGAN
Location Address4301 W MARKHAM ST # 543Little Rock, AR 72205-7101
Mailing Address2201 Blackwood RdLittle Rock, AR 72207-3420 · (501) 520-7484
Sole ProprietorYes
Enumeration DateMarch 25, 2024
NPPES CertifiedMarch 21, 2024
NPI 1922858802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4301 W MARKHAM ST # 543, Little Rock, AR 72205

Secondary Practice Location 1

Location 11 Childrens Way # 836Little Rock, AR 72202-3500 · Phone (501) 686-7501

Medicare Participation & PECOS Enrollment Status

Andrew Mangan 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

  • 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

Reviews for ANDREW REYNOLDS MANGAN

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Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Otolaryngology
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology (Plastic Surgery within the Head & Neck)
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology (Plastic Surgery within the Head & Neck)
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology (Plastic Surgery within the Head & Neck)
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology (Plastic Surgery within the Head & Neck)
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205
Otolaryngology
4301 W MARKHAM ST # 543
LITTLE ROCK, AR 72205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922858802, enumerated as an "individual" on March 25, 2024.

The provider is located at 4301 W MARKHAM ST # 543 LITTLE ROCK, AR 72205 and the phone number is (501) 603-1214.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.