Individual provider Active NPI

Karl Joseph Mangold, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Missoula, MT
National Provider Identifier
1659528263
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
174 Issued in MT
Practice address
2825 Stockyard Rd
Suite J-1
Missoula, MT 59808-1503
Phone
(406) 543-5333
Fax
(406) 543-5621
NPI assigned
Aug 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 174 MT Primary

Addresses

Primary practice location

2825 Stockyard Rd
Suite J-1
Missoula, MT 59808-1503

Mailing address

2825 Stockyard Rd
Suite J-1
Missoula, MT 59808-1503
Phone (406) 543-5333

Other identifiers 1

IdentifierTypeStateIssuer
0000298622MedicaidMT

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

LicenseStateTypeSpecialty
174MTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Mobile Wound Care Foot & Ankle Surgery CurrentSince Aug 1, 2024 Accepting new patients

Locations

2825 Fort Missoula Rd
Ste 106
Missoula, MT 59804
Phone (406) 543-5333

Interoperability endpoints

  • Direct secure messaging: karl.mangold@wmfaap-mt.direct.office.nextgen.com

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1659528263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD",
            "address_2": "SUITE J-1",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081503",
            "telephone_number": "406-543-5333",
            "fax_number": "406-543-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD",
            "address_2": "SUITE J-1",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081503",
            "telephone_number": "406-543-5333",
            "fax_number": "406-543-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGOLD",
        "first_name": "KARL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MT",
            "license": "174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000298622",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.