Active NPI
Cheryl Mangers
- Nurse Practitioner
- Champaign, IL
National Provider Identifier
1407862162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209-002934
- Practice address
- 101 W University Ave
Champaign, IL 61820-3909 - Phone
- (217) 366-5332
- Fax
- (217) 366-6106
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209-002934 | IL | Primary |
Addresses
Primary practice location
101 W University Ave
Champaign, IL 61820-3909
Mailing address
101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1326
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500008011 | Other | RAILROAD MEDICARE | |
| 433990 | Other | MEDICARE GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-002934 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379894400000",
"number": "1407862162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203909",
"telephone_number": "217-366-1326",
"fax_number": "217-366-6106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203909",
"telephone_number": "217-366-5332",
"fax_number": "217-366-6106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGERS",
"first_name": "CHERYL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2013-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209-002934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500008011",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "433990",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.