Mangum Primary Care LLC
NPI 1194494229 · Primary Care Clinic/Center · Boise, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mangum Primary Care LLC is a Primary Care Clinic/Center organization in Boise, ID (NPI 1194494229).
Provider details
- NPI number
- 1194494229
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Meredith Mangum, Owner(801) 793-8124
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 3050 N Lakeharbor Ln Ste 120Boise, ID 83703-6917Phone: (208) 550-3456
Registry dates
- Enumerated
- 2021-09-11
- Last updated
- 2021-09-11
- Certified
- 2021-09-11
Frequently asked questions
- What is Mangum Primary Care LLC's NPI number?
- Mangum Primary Care LLC's National Provider Identifier (NPI) is 1194494229, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mangum Primary Care LLC?
- Mangum Primary Care LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Mangum Primary Care LLC located?
- Mangum Primary Care LLC's practice location on file with NPPES is 3046 S Bown Way, Boise, ID 83706-5499.
- What is Mangum Primary Care LLC's phone number?
- The practice phone number listed in the NPPES registry for Mangum Primary Care LLC is (801) 793-8124.
- Does Mangum Primary Care LLC accept Medicare?
- Mangum Primary Care LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mangum Primary Care LLC?
- The authorized official listed on Mangum Primary Care LLC's NPPES record is Meredith Mangum, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mangum Primary Care LLC's NPI active?
- Yes — Mangum Primary Care LLC's NPI (1194494229) is active in the NPPES registry as of the last update on 2021-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.