MARTIN A MANGAN (NPI# 1972709103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972709103 |
| Entity Type | Individual |
| Full Name | MARTIN A MANGAN |
| Credential | DO |
| Practice Address |
10717 W State Street Star ID 83669 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2083026300 |
| Practice Fax Number | 2083026355 |
| Mailing Telephone | 2083026300 |
| Mailing Fax Number | 2083026355 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2016-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | O-0518 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | STATE LICENSE | MR 0934 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104873108 | Martin Joseph Mangan IIi | Family Medicine | 1055 Dove Run Rd, Suite 200, Lexington, KY 40502-3536 | 2006-05-27 |
| Street Address |
10717 W STATE STREET |
| City | STAR |
| State | ID |
| Zip Code | 83669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649589664 | Katherine Lea Mcdonough | Family Medicine | 10717 W State Street, Star, ID 83669 | 2010-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| 1285014779 | Boise River Physical Therapy | Physical Therapist | 64 S Star Road, Suite 2, Star, ID 83669 | 2015-06-01 |
| 1003250754 | Carol Tidwell | Counselor | 11104 W State St, Star, ID 83669 | 2013-04-24 |
| 1780816652 | Mark Olsen | Dentist | 12192 Evely Pines Ln, Star, ID 83669 | 2009-08-11 |
| 1770759912 | Richard E. Adams | Chiropractor | 11231 W Hercules Dr A, Star, ID 83669 | 2008-05-07 |
| 1861674707 | Keen Eye Vision Pllc | Optometrist | 170 South Seneca Springs Way, Suite 100, Star, ID 83669 | 2007-12-03 |
| 1639358773 | Natural Smile Dental Pllc | Dentist | 10706 W State St, Suite 105, Star, ID 83669 | 2007-10-25 |
| 1659566727 | Allied Mental Health Services, P.l.l.c. | Case Management | 11104 W. State St., Star, ID 83669 | 2007-09-11 |
| 1699021246 | Leslie Leet | Social Worker | 246 N Main St, Star, ID 83669 | 2012-08-01 |
| 1780826594 | Allied Mental Health Services, P.l.l.c. | Community/Behavioral Health | 11104 W. State St., Star, ID 83669 | 2009-03-26 |
| Find all providers in zip 83669 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609083658 | Thomas Richard Young IIi | Family Medicine | 4815 N High Country Way, Star, ID 83669-5309 | 2007-05-17 |
| 1649589664 | Katherine Lea Mcdonough | Family Medicine | 10717 W State Street, Star, ID 83669 | 2010-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375659 | Jonathan Barrus Do PC | Family Medicine | 2020 S Johns Avenue, Emmett, ID 83617 | 2020-10-29 |
| 1750998126 | Story Family Medicine | Family Medicine | 1150 Alturas Dr Ste 101, Moscow, ID 83843-3263 | 2020-09-29 |
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1447880570 | Bore LLC | Family Medicine | 1498 Midway Ave Ste 2, Ammon, ID 83406-4587 | 2020-01-16 |
| 1669038220 | Savannah M Klinginsmith | Family Medicine | 17866 Polara Way, Nampa, ID 83687-9159 | 2019-05-18 |
| 1487218814 | Logan Perkins | Family Medicine | 132 5th Ave W Ste 2, Jerome, ID 83338-1825 | 2019-05-01 |
| 1588227656 | Traci H Permenter | Family Medicine | 943 N Linder Rd Ste 103, Kuna, ID 83634-3395 | 2019-04-15 |
| 1790244424 | Destin Thayne Bep Inc | Family Medicine | 859 S Yellowstone Hwy Ste 304, Rexburg, ID 83440-5294 | 2019-03-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| Find all providers with the same taxonomy | ||||
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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.