Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SCOTT RYAN MANGUM, PA-C
ActiveSCOTT RYAN MANGUM, PA-C is a Medical Physician Assistant healthcare provider located in BLACKFOOT, Idaho. NPI 1043180730 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · BLACKFOOT, ID
Registration Details
- NPI Number
- 1043180730
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 7, 2025 (0.80398480931034 yrs)
- Last Updated
- Nov 7, 2025
- License
-
7371782 (ID)
Practice Information
- Address
-
98 POPLAR STBLACKFOOT, ID, 832211799Browse ID providers · Browse ZIP 83221
- Phone
- 2087854100
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in BLACKFOOT, ID
| Name | Credential | NPI |
|---|---|---|
| MRS. STACY COOPER | PA-C | 1518157544 |
| RYAN BLAIR KILLPACK | PA-C | 1114405396 |
| JUSTIN GREGG NELSON | PA-C | 1790403178 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.