Active NPI
Ami Mange
- Student in an Organized Health Care Education/Training Program
- Saint Louis, MO
National Provider Identifier
1548191703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 2026027276
- Practice address
- 4590 Nash Way
Saint Louis, MO 63110-1020 - Phone
- (314) 362-1930
- NPI assigned
- May 27, 2026
- Last updated
- Jun 16, 2026
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 2026027276 | MO | Primary |
Addresses
Primary practice location
4590 Nash Way
Saint Louis, MO 63110-1020
Mailing address
111 Park St Apt 7S
New Haven, CT 06511-5455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260625001173 | MO | Order and Referring Only - Neurology | 6406329010 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2026027276 | MO | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781568000000",
"number": "1548191703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 PARK ST APT 7S",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4590 NASH WAY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101020",
"telephone_number": "314-362-1930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGE",
"first_name": "AMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-27",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MO",
"license": "2026027276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.