Individual provider Active NPI

Ashleigh Chase Mangrum, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1609487933
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8585 S Eastern Ave
Las Vegas, NV 89123-2817
Phone
(702) 798-8585
Fax
(702) 341-0109
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8585 S Eastern Ave
Las Vegas, NV 89123-2817

Mailing address

8585 S Eastern Ave
Las Vegas, NV 89123-2817
Phone (702) 798-8585

Other practice location 1

915 E Market Ave
Searcy, AR 72149-5615
Phone (501) 279-5642

Other practice location 2

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3111

Other identifiers 3

IdentifierTypeStateIssuer
Q074386MedicaidTN
005306518MedicaidMS
09010261MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220602000584 TN Practitioner - Physician Assistant 2668850876 Reassigns benefits to 1 organization
I20250218002205 NV Practitioner - Physician Assistant 2668850876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vahey and Gluck Hand Surgery, LTDGroup PAC ID 0244598084, 5 clinicians

Practice addresses (Care Compare)

8585 S Eastern Ave
Suite 100
Las Vegas, NV 89123-2818
Phone (702) 798-8585

Hospital & facility affiliations

  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • Henderson Hospital Hospital, Henderson, NV, CCN 290057
  • West Henderson Hospital Hospital, Henderson, NV, CCN 290062

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5005TNMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Walant ASC LLC CurrentSince Jul 21, 2024 Accepting new patients
Titan Orthopedics of Memphis, PLLC CurrentSince May 13, 2022 Accepting new patients
CC Bpci PLC Past Accepting new patients

Locations

8585 S Eastern Ave
Las Vegas, NV 89123
Phone (702) 798-8585

8585 S Eastern Ave
Ste 100
Las Vegas, NV 89123
Phone (702) 798-8585

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14704/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1609487933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232817",
            "telephone_number": "702-798-8585",
            "fax_number": "702-341-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232817",
            "telephone_number": "702-798-8585",
            "fax_number": "702-341-0109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 E Market Ave",
            "address_purpose": "LOCATION",
            "city": "Searcy",
            "state": "AR",
            "postal_code": "721495615",
            "country_code": "US",
            "telephone_number": "501-279-5642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 S Germantown Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381382205",
            "country_code": "US",
            "telephone_number": "901-759-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGRUM",
        "first_name": "ASHLEIGH",
        "middle_name": "CHASE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q074386",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005306518",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09010261",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.