P Praxis·MD
● Active Type 1 · Individual

Scott Ryan Mangum, PA-C

Physician Assistant·Blackfoot, ID· NPI 1043180730 · Enumerated 2025 · 0 years on NPI
Mangum is 1 of 4 physician assistant providers in Blackfoot and 1 of 387 in Idaho.
NPI age
— years
Enumerated 2025-11-07
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2025-11-07
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 387 active physician assistant providers in Idaho.

NPI age
0 years
↓ 15 yr below median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties

NPI lifetime · 2025 → 2026

2025-11Enumerated in NPPES
2025 2026

Where they practice

Practice location
98 Poplar St
Blackfoot, ID 832211799
📞 2087854100
Mailing address
98 Poplar St
Blackfoot, ID 832211799
📞 2087854100

Specialties

  • Physician Assistant Primary
    Definition to come...
    ID license #7371782 taxonomy 363AM0700X

Practice context

Part of a multi-provider practice. 107 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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