Individual provider Active NPI

Nelson J Mangione, MD

  • Cardiovascular Disease Physician
  • Smyrna, TN
National Provider Identifier
1164504544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
21023 Issued in TN
Practice address
300 Stonecrest Blvd
Suite 410
Smyrna, TN 37167
Phone
(615) 832-8731
Fax
(615) 833-5178
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 21023 TN Primary

Addresses

Primary practice location

300 Stonecrest Blvd
Suite 410
Smyrna, TN 37167

Mailing address

397 Wallace Road
Suite 216
Nashville, TN 37211
Phone (615) 832-8731

Other identifiers 1

IdentifierTypeStateIssuer
3706183MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226000085 TN Practitioner - Cardiovascular Disease (Cardiology) 2567361876 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21023TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Heart & Vascular, PLLC Cardiovascular Disease CurrentSince Jul 1, 2020 Accepting new patients
Centennial Heart LLC Cardiovascular Disease CurrentSince Jul 16, 2007 Accepting new patients
Saint Thomas Cardiology Consultants, PC Cardiovascular Disease Past Accepting new patients

Locations

310 W Tyler Ave
West Memphis, AR 72301
Phone (870) 732-2398

7751 Wolf River Blvd
Germantown, TN 38138
Phone (901) 297-4000

2400 Patterson St
Ste 502
Nashville, TN 37203
Phone (615) 515-1968

2400 Patterson St
Ste 103
Nashville, TN 37203
Phone (615) 329-0929

300 Stonecrest Blvd
Ste 410
Smyrna, TN 37167
Phone (615) 220-6144

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164504544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 WALLACE ROAD",
            "address_2": "SUITE 216",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37211",
            "telephone_number": "615-832-8731",
            "fax_number": "615-833-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD",
            "address_2": "SUITE 410",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "37167",
            "telephone_number": "615-832-8731",
            "fax_number": "615-833-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIONE",
        "first_name": "NELSON",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "21023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3706183",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

Verify at the official NPI Registry.