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

Q: What is Andrew Mangan's NPI number?

The NPI number for Andrew Mangan is 1922858802. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Q: What is Andrew Mangan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Mangan was last updated on March 25, 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.

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: August 09, 2026.

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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

Phone(501) 603-1214

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

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

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

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Secondary Practice Location 1

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Reynolds Mangan 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.

Other Providers at the Same Location NPPES 15

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

DR. OLIVIA E SPEED MD

Student in an Organized Health Care Education/Training Program