Susan Patricia Mangum, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

515148 Issued in TX

Practice address

2221 Buena Vista St
San Antonio, TX 78207-3702

Phone

(210) 225-3524

Fax

(210) 225-2081

NPI assigned

Nov 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susan.mangum.1@27691.direct.athenahealth.com

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.

• Dandan Primary Care, LLC

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1235804964
  Medicare reassignment
• Garza Medical Group @ South Alamo

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1396231320
  Medicare reassignment
• Edge-MD Holding PLLC

  • Physiological Laboratory
  • Irving, TX
  • NPI 1497222343
  NPD
• Thomas C. Wascher, M.D.

  • General Practice Physician
  • San Antonio, TX
  • NPI 1710239900
  NPD (past)
• Veda Medical, LLC

  • Plastic and Reconstructive Surgery Physician
  • Cibolo, TX
  • NPI 1891221636
  NPD (past)

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1962657486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 NW LOOP 410",
            "address_2": "STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305105",
            "telephone_number": "210-225-3524",
            "fax_number": "210-225-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 BUENA VISTA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073702",
            "telephone_number": "210-225-3524",
            "fax_number": "210-225-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "SUSAN",
        "middle_name": "PATRICIA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "515148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandeep Mangat, MD
• Anna Mangiafico, NNP
• Cheyenne Mackenzie Mangold, MD
• Nadira Mangra
• James Kristopher Mangrum, FNP-C
• Sellina Manila
• Kathy Marie Manka, PT
• Seema Mankodi, DDS
• Erin Blankenship Mankus, M.D.
• Jennifer Manley, RBT

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.