Jadeka Motley Mangrum, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5018483 Issued in NC

Practice address

700 Walter Reed Dr
Greensboro, NC 27403-1128

Phone

(336) 210-5641

NPI assigned

Jul 19, 2023

Last updated

Jul 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Medicare enrollment (NPD)

Enrolled

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.

• The Moses H. Cone Memorial Hospital Operating Corporation

  dba Cone Health Sickle Cell Center

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Alamance Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Burlington, NC
  • NPI 1326010273

  Single Specialty

  Medicare reassignment NPD
• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1306167713

  Single Specialty

  Medicare reassignment NPD
• Alamance Regional Medical Center, Inc

  dba ARMC Health Care Employee Pharmacy

  • Pharmacy
  • Burlington, NC
  • NPI 1851681993
  NPD
• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Pharmacy
  • New Bern, NC
  • NPI 1013769629
  NPD
• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Yanceyville, NC
  • NPI 1437367174

  Single Specialty

  NPD

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

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1407536956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 GLENDALE DR APT H",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274066469",
            "telephone_number": "362-105-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WALTER REED DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031128",
            "telephone_number": "336-210-5641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Glendale Dr Apt H",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274066469",
            "country_code": "US",
            "telephone_number": "336-210-5641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTLEY MANGRUM",
        "first_name": "JADEKA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5018483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karys Michaela Mossa, PHD
• Lubna Mostafa
• Andrew Mota
• Motion Enterprise LLC
• Motion Enterprise LLC
• Christina Hudgins Motley, MA,LCMHC, BC-DMT
• Marjorie Moore Moton, PT
• Margie Gibbs Motsinger, SLP
• Shelly Mabe Motsinger, RN
• Michelle H Mottinger, DDS

• Psychiatric/Mental Health Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.