Individual provider Active NPI

Bridget Mangan, CNM

  • Advanced Practice Midwife
  • Charlottesville, VA
National Provider Identifier
1063267920
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024190040 Issued in VA
Practice address
2955 Ivy Rd Ste 304
Charlottesville, VA 22903-9353
Phone
(434) 243-4570
Fax
(434) 295-5491
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0024190040 VA
Advanced Practice Midwife 367A00000X 0024190040 VA Primary

Addresses

Primary practice location

2955 Ivy Rd Ste 304
Charlottesville, VA 22903-9353

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240517003448 VA Practitioner - Certified Nurse Midwife (CNM) 8123469350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2955 Ivy Rd
Suite 304
Charlottesville, VA 22903-9353
Phone (434) 243-4570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
0024190040VAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Apr 29, 2024 Accepting new patients

Locations

2955 Ivy Rd
Ste 304
Charlottesville, VA 22903
Phone (434) 243-4570

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

Interoperability endpoints

  • Direct secure messaging: bmangan630543@direct.healthsystem.virginia.edu

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1063267920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 IVY RD STE 304",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229039353",
            "telephone_number": "434-243-4570",
            "fax_number": "434-295-5491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-2500",
            "fax_number": "434-243-9240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGAN",
        "first_name": "BRIDGET",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0024190040",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024190040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.