Melissa Mangan, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F06211243 Issued in MN

Practice address

15725 37TH Ave N Ste 1
Plymouth, MN 55446-3206

Phone

(612) 305-8825

Fax

(763) 322-9114

NPI assigned

Jun 16, 2021

Last updated

Aug 12, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Kempenich Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Minneapolis Integrative Medicine Center, LLC

  • General Practice Physician
  • Wayzata, MN
  • NPI 1447857230
  NPD

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1386212173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 37TH AVE N STE 1",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463206",
            "telephone_number": "612-305-8825",
            "fax_number": "763-322-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 37TH AVE N STE 1",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463206",
            "telephone_number": "612-305-8825",
            "fax_number": "763-322-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAN",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "F06211243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "KEMPENICH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colin Joseph Maguire, DDS
• Kavitha Malango, NP
• Nadia Malik, M.D
• Matthew Lee Mallinger, BS, ATC, OTC
• Lindsay Lee Maloney, PA
• Marina Rose Mankee, PHARMD
• Ava Mannion, CCC-SLP
• Cindi Lynn Mansur, P.A.
• Margg Home Care LLC (FirstLight Home Care of Plymouth MN)
• Michelle Marin

• Nurse Practitioner in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.