Ruth Roberta Mangino, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP3232 Issued in AZ

Practice address

7330 N 99TH Ave Ste 325
Glendale, AZ 85307-3022

Phone

(623) 209-1474

Fax

(623) 209-1475

NPI assigned

Jan 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1740459700
  NPD (past)

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1194961664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322139",
            "telephone_number": "602-633-3838",
            "fax_number": "602-633-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 N 99TH AVE STE 325",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853073022",
            "telephone_number": "623-209-1474",
            "fax_number": "623-209-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGINO",
        "first_name": "RUTH",
        "middle_name": "ROBERTA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-05",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN087831",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403458",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z204343",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mancuso Chiro Center LLC
• David A Mancuso, D.C.
• Mandeep K Rai PLC
• Poonam Manek, NP
• Timothy Mangin
• Kayla Mangold
• Annalyce Manka, PT, DPT
• Sherri Mankofsky, RD
• Ajitpal Singh Mann, MD
• Amanda Manning

• Adult Health Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.