Mangat Medical LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300163 Issued in KY

Legal business name

MANGAT MEDICAL LLC

Doing business as

The Surgery Center LLC

Practice address

133 Barnwood Dr
Edgewood, KY 41017-2500

Phone

(859) 426-1616

Fax

(859) 578-3321

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Nelson Bright Rue III, RN, MBA, CHE, CASC

Title

Executive Director

Phone

(859) 426-1616

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Surgery Center LLC Doing business as

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1669520318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BARNWOOD DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410172500",
            "telephone_number": "859-426-1616",
            "fax_number": "859-578-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BARNWOOD DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410172500",
            "telephone_number": "859-426-1616",
            "fax_number": "859-578-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGAT MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "RUE",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "BRIGHT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "859-426-1616",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RN, MBA, CHE, CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC LICENSE",
            "identifier": "300163",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAHC",
            "identifier": "69897",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Surgery Center LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Martin Mai, APRN
• Brittany Majszak, APRN
• James Michael Makinen, MD
• Kyra M Mallery, RBT
• Kristine Marie Maloney, CRNA
• Devinder S Mangat, M.D.
• Nicole Mangus, APRN
• Ahmad T Mansour, MD
• Cheyenne Marcum
• Mark Modlin, Inc.

• Ambulatory Surgical Clinic/Center in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.