Individual provider Active NPI

Emily Mangham, NP-C

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1295215333
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0994013-NP Issued in CO
Practice address
2875 International Cir
Colorado Springs, CO 80910-3144
Phone
(719) 389-0071
NPI assigned
Aug 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0994013-NP CO Primary

Addresses

Primary practice location

2875 International Cir
Colorado Springs, CO 80910-3144

Mailing address

7225 Julynn Rd
Colorado Springs, CO 80919-5034
Phone (719) 217-6189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20181219001382 CO Practitioner - Nurse Practitioner 2769727734 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0994013-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munni Selagamsetty,MD,PC CurrentSince Dec 3, 2018 Accepting new patients
Internal Medicine of the Rockies PastSince Dec 3, 2018 Accepting new patients

Locations

2875 International Cir
Colorado Springs, CO 80910
Phone (719) 389-0070

Organizations & group practices 2

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1295215333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7225 JULYNN RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809195034",
            "telephone_number": "719-217-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 INTERNATIONAL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103144",
            "telephone_number": "719-389-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGHAM",
        "first_name": "EMILY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0994013-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.