Individual provider Active NPI

Brittney Mahnke, ACNP-AG

  • Gerontology Nurse Practitioner
  • Lake Havasu City, AZ
National Provider Identifier
1265091276
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
225684 Issued in AZ
Practice address
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Phone
(928) 302-5402
Fax
(928) 302-5906
NPI assigned
Jun 12, 2019
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 225684 AZ
Gerontology Nurse Practitioner 363LG0600X 225684 AZ Primary

Addresses

Primary practice location

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Mailing address

781 Rolling Hills Dr
Lake Havasu City, AZ 86406-7193
Phone (928) 208-6089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20200116001432 AZ Practitioner - Nurse Practitioner 5193150308 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group IncGroup PAC ID 2961314265, 85 clinicians
Lakeside Heart and Vascular Center PLLCGroup PAC ID 4587832779, 20 clinicians

Practice addresses (Care Compare)

101 Civic Ctr LN
Lake Havasu City, AZ 86403-5607
Phone (928) 855-8185

2082 Mesquite Ave
Suite 100a
Lake Havasu City, AZ 86403-6710
Phone (928) 453-2727

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.61 of 100Reported as group
Quality
100
Improvement activities
40
Cost
88.22

Merit-based Incentive Payment System (MIPS)

Final score
79.85 of 100Reported as group
Quality
60.31
Promoting interoperability
93
Improvement activities
40
Cost
78.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
225684AZMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Inc CurrentSince Dec 1, 2019 Accepting new patients
Apogee Medical Group Inc CurrentSince Dec 1, 2019 Accepting new patients
Lakeside Heart and Vascular Center PLLC CurrentSince May 1, 2023 Accepting new patients
Southwest Primary Care LTD CurrentSince Mar 1, 2020 Accepting new patients
Executive Cardiac Arrhythmia Solutions, Inc Past Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1741 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 733-6351

1810 Mesquite Ave
Ste A
Lk Havasu Cty, AZ 86403
Phone (520) 855-5146

1987 McCulloch Blvd N
Ste 101
Lk Havasu Cty, AZ 86403
Phone (904) 994-5560

2010 Injo Dr
Lk Havasu Cty, AZ 86403
Phone (623) 227-1000

2082 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 453-2828

297 Lake Havasu Ave S
Ste 204
Lk Havasu Cty, AZ 86403
Phone (928) 453-1970

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

Interoperability endpoints

  • Direct secure messaging: brittney.mahnke.1@3291.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3291/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1265091276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 ROLLING HILLS DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864067193",
            "telephone_number": "928-208-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-302-5402",
            "fax_number": "928-302-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNKE",
        "first_name": "BRITTNEY",
        "credential": "ACNP-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "225684",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "225684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.