DR. ALICIA MANGRAM (NPI# 1972575504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972575504 |
| Entity Type | Individual |
| Full Name | DR. ALICIA MANGRAM |
| Credential | MD |
| Practice Address |
16601 N 40th St Ste 227 Phoenix AZ 85032-3354 |
| Practice Telephone | 6026333721 |
| Practice Fax Number | 6025951127 |
| Mailing Telephone | 6026333721 |
| Mailing Fax Number | 6025951127 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2019-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
45385 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 144729405 | 05 |
| Street Address |
16601 N 40TH ST STE 227 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85032-3354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043854623 | Dee Alley Ensign | Physician Assistant | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2019-11-06 |
| 1376027557 | Charles Douglas Balcome | Nurse Practitioner | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2018-09-24 |
| 1548756794 | Dustin Richard Husemann | Nurse Practitioner | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2018-07-10 |
| 1164809893 | Jennifer Rae Quezada | Registered Nurse | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2015-05-01 |
| 1770998007 | Thomas Cox | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2014-06-25 |
| 1164765731 | Tony Dunne | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2013-04-02 |
| 1649546193 | Ace Assaf Ovil | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2012-03-29 |
| 1831464858 | Alyssa Kristine Stassi | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2012-03-09 |
| 1821370974 | Affordable Family Practice, Inc. | Family Medicine | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2011-09-14 |
| 1891012225 | Hoang Lim | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2010-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298838 | Eboni Nicole Morris | Psychologist | 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 | 2020-06-03 |
| 1326688573 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3227 E Bell Road, Suite 170, Room P1, Phoenix, AZ 85032 | 2020-01-15 |
| 1740836642 | Integrated Medical Services Inc | Internal Medicine | 3815 W Bell Rd, Ste 3200, Phoenix, AZ 85032 | 2019-08-15 |
| 1639739576 | Sarah Martin | Physical Therapy Assistant | Ridgecrest Healthcare, 16640 North 38th Street, Phoenix, AZ 85032 | 2019-06-13 |
| 1750846168 | Conte Sport Performance Therapy LLC | Physical Therapist | 18413 N. Cave Creed Rd, Suite 8, Phoenix, AZ 85032 | 2019-02-11 |
| 1659848208 | Pacific Dental Services Foundation | Physician Assistant | 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 | 2018-10-31 |
| 1083100812 | Phoenix Interventional Pain Management, Pllc | Anesthesiology | 3815 E Bell Rd Ste 3500a, Phoenix, AZ 85032 | 2018-07-04 |
| 1770074635 | Np Professional LLC | Clinic/Center | 3329 E Bell Rd Ste A1, Phoenix, AZ 85032 | 2018-05-25 |
| 1932600020 | North Phoenix Asc LLC | Clinic/Center | 3329 E Bell Rd Ste A2-a5, Phoenix, AZ 85032 | 2018-02-23 |
| 1396263307 | Cheryl Anne Miller | Registered Nurse | 15002 N. 32nd St., Phoenix, AZ 85032 | 2017-08-30 |
| Find all providers in zip 85032 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205095817 | Andrews C Ninan | Surgery | 2601e Roosevelt Street, Maricopa Medical Center, Phoenix, AZ 85008 | 2008-06-09 |
| 1437206562 | Nicole P Piscatelli | Surgery | 3141 N 48th St, Phoenix, AZ 85018-6564 | 2007-01-04 |
| 1154438133 | Michael Corneille | Surgery | 9250 N 3rd Sreet, Suite 3015, Phoenix, AZ 85020-2425 | 2006-08-24 |
| 1447729975 | Valley Associates Prs Pllc | Surgery | 10910 N Tatum Blvd Ste B100, Phoenix, AZ 85028-3080 | 2018-11-14 |
| 1114400314 | Kma Surgical Assist LLC | Surgery | 901 E Jefferson St, Phoenix, AZ 85034-2219 | 2018-09-13 |
| 1619200722 | District Medical Group, Inc | Surgery | 2525 E Roosevelt St, Surgery Clinic, Phoenix, AZ 85008-4948 | 2009-09-09 |
| 1831324383 | Scottsdale Acute Care Surgery, LLC | Surgery | 9250 N 3rd St, Suite 3000, Phoenix, AZ 85020-2437 | 2009-05-27 |
| 1447430491 | Francis Reginald Ali-osman | Surgery | 16601 N 40th St Ste 227, Phoenix, AZ 85032-3354 | 2007-11-07 |
| 1669590543 | Mark Steven Molitor Jr. | Surgery | 1920 E Cambridge Ave, Suite #201, Phoenix, AZ 85006-1459 | 2007-03-27 |
| 1407941602 | Michael D. Peck | Surgery | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2006-10-04 |
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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.