Julia B Mangan, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NP334A Issued in ID

Practice address

1112 W Ironwood Dr
Coeur D Alene, ID 83814-2474

Phone

(208) 664-8818

Fax

(208) 664-4427

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Saint Padre Pio Family Medicine, PLLC

  • Family Medicine Physician
  • Post Falls, ID
  • NPI 1295683662
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1902912256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 W IRONWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142474",
            "telephone_number": "208-664-8818",
            "fax_number": "208-664-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 W IRONWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142474",
            "telephone_number": "208-664-8818",
            "fax_number": "208-664-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAN",
        "first_name": "JULIA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "NP334A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805117600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Malloy, P.T.
• Wendi Malmgren, LMSW
• Jared M Malone, LMSW
• Benjamin Mandel, M.D.
• Megan Marie Maney, P.T.
• Roger Paul Mangum, RPH
• Kameron Manley
• Jamie Joanne Mann, BS
• Ashley Dawn Manning, PA-C
• Sausha Mannon, DENTURIST

• Family Medicine Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.