HEATHER M MANGUM (NPI# 1750318143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750318143 |
| Entity Type | Individual |
| Full Name | HEATHER M MANGUM |
| Credential | CFNP |
| Practice Address |
6250 Old Canton Rd Ste 100 Jackson MS 39211 |
| Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
| Practice Telephone | 6019571015 |
| Mailing Telephone | 9012273255 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 855922 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09280549 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 106 Clinton Pkwy, Clinton, MS 390564730 | 6019249005 | |
| 1200 N State St Ste 500, Jackson, MS 392022027 | 6013522273 | |
| 1201 Highway 49 S Ste 1, Richland, MS 392189438 | 6019731576 | |
| 1225 N State St, Jackson, MS 392022064 | 6019925532 | |
| 1490 W Government St Ste 10, Brandon, MS 390423024 | 6018251936 | |
| 151 E Metro Dr Ste 103, Flowood, MS 392324405 | 6019923288 | |
| 1887 Spillway Rd, Brandon, MS 390476066 | 6019925532 | |
| 2173 Main St, Madison, MS 391106309 | 6016053858 | |
| 2500 N State St, Department of Medicine/division of Infectious Diesease, Jackson, MS 392164500 | 6019845560 | |
| 3011 Greenfield Rd, Pearl, MS 392088712 | 6018259000 | |
| 401 Baptist Dr Ste 104, Madison, MS 391102010 | 6016052383 | |
| 7275 S Siwell Rd, Byram, MS 392729767 | 6013737722 |
| Street Address |
6250 OLD CANTON RD STE 100 |
| City | JACKSON |
| State | MS |
| Zip Code | 39211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295963007 | Cynthia Colson Garrett | Family Medicine | 6250 Old Canton Rd Ste 100, Jackson, MS 39211-2946 | 2009-06-30 |
| 1053434555 | Medical Foundation of Central Mississippi, Inc | Family Medicine | 6250 Old Canton Rd Ste 100, Jackson, MS 39211-2946 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332546 | Jaleesa Atkins | Nurse Practitioner | 4266 Springbrook Rd, Jackson, MI 49201-9716 | 2020-07-01 |
| 1457983785 | Amos N Macharia | Nurse Practitioner | 2130 Ridge Rd, Jackson, MO 63755-1612 | 2020-02-05 |
| 1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
| 1851934723 | Hannah Louise Keel | Nurse Practitioner | 623 Gettysburg Dr, Jackson, TN 38305-7886 | 2019-10-23 |
| 1013559186 | Kirsten Siler | Nurse Practitioner | 27a Medical Center Drive, Jackson, TN 38301-3949 | 2019-10-10 |
| 1801447693 | Milestone Primary Care House Calls, LLC | Nurse Practitioner | 5260 Cedar Park Dr Ste E, Jackson, MS 39206-4131 | 2019-09-24 |
| 1750855870 | Michael L Chesney | Nurse Practitioner | 6055 Jordan Rd, Jackson, MI 49201-9580 | 2019-01-12 |
| 1609356500 | Angela Sophia Mcreynolds | Nurse Practitioner | 2500 N State St Rm S347, Jackson, MS 39216-4500 | 2018-08-20 |
| 1679050132 | Alicia Faye Green | Nurse Practitioner | 908 Bella Vista Dr, Jackson, MO 63755-7863 | 2018-07-26 |
| 1982119228 | Felix Taylor | Nurse Practitioner | 514 E Woodrow Wilson Ave Ste B, Jackson, MS 39216-4538 | 2017-12-08 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.