Nicole Mangus, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3014214 Issued in KY

Practice address

1 Medical Village Dr
Edgewood, KY 41017-3403

Phone

(859) 301-2250

Fax

(859) 572-2326

NPI assigned

Jan 16, 2020

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 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Compass Emergency Physicians PSCGroup PAC ID 8224350939, 83 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.13 of 100Reported as group

Quality

89.38

Improvement activities

40

Cost

79.98

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Compass Emergency Physicians PSC

  • Emergency Medicine Physician
  • Edgewood, KY
  • NPI 1841696739

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1972133098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18667",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410180667",
            "telephone_number": "859-572-3617",
            "fax_number": "859-572-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2250",
            "fax_number": "859-572-2326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "238 Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Williamstown",
            "state": "KY",
            "postal_code": "410979482",
            "country_code": "US",
            "telephone_number": "859-824-8240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 James Simpson Jr Way",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410110801",
            "country_code": "US",
            "telephone_number": "859-655-4353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGUS",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0387021",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100648190",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Michael Makinen, MD
• Kyra M Mallery, RBT
• Kristine Marie Maloney, CRNA
• Mangat Medical LLC
• Devinder S Mangat, M.D.
• Ahmad T Mansour, MD
• Cheyenne Marcum
• Mark Modlin, Inc.
• Byron W Marks, MD
• Danielle Marie Marsh, NP

• Nurse Practitioner in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.