Individual provider Active NPI

Bobbi Lynn Mangrum, APRN-CNP

  • Adult Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1720359318
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
81137 Issued in OK
Practice address
1265 S Utica Ave Ste 300
Tulsa, OK 74104-4243
Phone
(918) 592-0999
Fax
(918) 592-1021
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 81137 OK Primary

Addresses

Primary practice location

1265 S Utica Ave Ste 300
Tulsa, OK 74104-4243

Mailing address

9228 S Mingo Rd Ste 200
Tulsa, OK 74133-5722
Phone (918) 592-0999

Other practice location 1

1328 S York St
Muskogee, OK 74403-7650
Phone (918) 683-0470 ext. 2007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20140617000020 OK Practitioner - Nurse Practitioner 1355565268 Reassigns benefits to 2 organizations
I20151118001576 TX Practitioner - Nurse Practitioner 1355565268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243
Phone (918) 592-0999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Sep 23, 2018 Accepting new patients
Cherokee Nation CurrentSince Oct 12, 2015 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Sep 23, 2018 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince May 2, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Oct 12, 2015 Accepting new patients
Ahs Oklahoma Heart LLC CurrentSince Apr 1, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
Oklahoma Heart Inc Past Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients

Locations

1501 N Florence Ave
Ste 201
Claremore, OK 74017
Phone (918) 341-1886

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 855-2570

Dept 1218
Tulsa, OK 74182

Dept 1467
Tulsa, OK 74182

Dept 2269
Tulsa, OK 74182

Dept 1038
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: bmangrum169459@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4

Organizations & group practices 11

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 2

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": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1720359318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335722",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 S UTICA AVE STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044243",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1328 S York St",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744037650",
            "country_code": "US",
            "telephone_number": "918-683-0470 x2007",
            "fax_number": "918-683-0475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGRUM",
        "first_name": "BOBBI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "81137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.