Individual provider Active NPI

Kimberly Jo Manges, DNP, APRN, AGACNP-BC

  • Interventional Pain Medicine Physician
  • Carmel, IN
National Provider Identifier
1407512007
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
71017827A Issued in IN
Practice address
12289 Hancock St Ste 34
Carmel, IN 46032-5888
Phone
(317) 815-8950
Fax
(317) 815-8951
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 71017827A IN
Interventional Pain Medicine Physician 208VP0014X 71017827A IN Primary

Addresses

Primary practice location

12289 Hancock St Ste 34
Carmel, IN 46032-5888

Mailing address

12289 Hancock St Ste 34
Carmel, IN 46032-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20241209003909 IN Practitioner - Nurse Practitioner 8224561402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12289 Hancock St
Suite 34
Carmel, IN 46032-5888
Phone (317) 815-8950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1407512007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12289 HANCOCK ST STE 34",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12289 HANCOCK ST STE 34",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325888",
            "telephone_number": "317-815-8950",
            "fax_number": "317-815-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGES",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "71017827A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "71017827A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.