Individual provider Active NPI

Chelsie Kayten Mangum, ARNP

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1912397530
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9318711 Issued in FL
Practice address
704 Generation PT
Suite 201
Kissimmee, FL 34744-5918
Phone
(888) 644-1448
NPI assigned
Feb 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9318711 FL Primary

Addresses

Primary practice location

704 Generation PT
Suite 201
Kissimmee, FL 34744-5918

Mailing address

4511 La Salle Ave S Ste 10
Saint Cloud, FL 34772-8399
Phone (407) 797-3171

Other practice location 1

2521 13th St Ste C
Saint Cloud, FL 34769-4103
Phone (407) 797-3171

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
ARNP 9318711FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Risk Solutions Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DAAEBD

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": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1912397530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 LA SALLE AVE S STE 10",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728399",
            "telephone_number": "407-797-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 GENERATION PT",
            "address_2": "SUITE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445918",
            "telephone_number": "888-644-1448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2521 13th St Ste C",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347694103",
            "country_code": "US",
            "telephone_number": "407-797-3171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "CHELSIE",
        "middle_name": "KAYTEN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9318711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.