Scott Ryan Mangum, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7371782 Issued in ID

Practice address

98 Poplar St
Blackfoot, ID 83221-1799

Phone

(208) 785-4100

NPI assigned

Nov 7, 2025

Last updated

Nov 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Washington School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BMH IncGroup PAC ID 8426149758, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bingham Memorial Hospital Hospital, Blackfoot, ID, CCN 131325

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BMH, Inc.

  dba Bingham Memorial Physicians & Surgeons Center

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193
  Medicare reassignment Care Compare group NPD (past)
• BMH, Inc

  dba Bingham Healthcare Specialty Clinic - Terry St

  • Endocrinology, Diabetes & Metabolism Physician
  • Pocatello, ID
  • NPI 1255705786
  NPD
• BMH, Inc.

  dba 1st Choice Urgent Care & Medical Center-Chubbuck

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1043180730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211799",
            "telephone_number": "208-785-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211799",
            "telephone_number": "208-785-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "SCOTT",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "7371782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Love
• Mark Lupton, DO
• Jordan Lyon, LMSW
• Joshua Mackenzie
• Kywnynn Madsen
• Allison Marotz, REGISTERED DIETITIAN
• Dennis N Marshall, O.D., P.A.
• Akaila Martin, MSW
• Christiana Matson, LMSW
• Matthew F Kunz DDS PLLC Blackfoot

• Medical Physician Assistant in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.