Ms Kelly Renee Mangold, CRNA | |
3 Scarlet Oak Ct, Lake St Louis, MO 63367-2130 | |
(312) 919-6286 | |
Not Available |
Full Name | Ms Kelly Renee Mangold |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 15 Years |
Location | 3 Scarlet Oak Ct, Lake St Louis, Missouri |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477876803 | NPI | - | NPPES |
600420070 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 2010005602 (Missouri) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 6708 (North Carolina) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Jefferson City Medical Group Pc | 1850371089 | 100 |
Novamed Eye Surgery Center Of North County Llc | 6901866128 | 4 |
Entity Name | Joseph A Bendet Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881755288 PECOS PAC ID: 2163316258 Enrollment ID: O20040211000157 |
Entity Name | Jefferson City Medical Group Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336189398 PECOS PAC ID: 1850371089 Enrollment ID: O20040908000924 |
Entity Name | Dreamland Uap Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073919494 PECOS PAC ID: 9133442825 Enrollment ID: O20150105001419 |
Entity Name | Laser Spine Institute Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265483895 PECOS PAC ID: 5496759409 Enrollment ID: O20150226000992 |
Entity Name | Novamed Eye Surgery Center Of North County Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003260100 PECOS PAC ID: 6901866128 Enrollment ID: O20160720002627 |
Entity Name | Aim Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245685601 PECOS PAC ID: 3971896705 Enrollment ID: O20160801001265 |
Entity Name | Northstar Anesthesia Of Missouri Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396191789 PECOS PAC ID: 4082908249 Enrollment ID: O20160810001928 |
Entity Name | Key Anesthesia Partners |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467073742 PECOS PAC ID: 0547691180 Enrollment ID: O20200514000508 |
Entity Name | Olde Cabin Anesthesia |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780228155 PECOS PAC ID: 8426489048 Enrollment ID: O20200515000838 |
Entity Name | Cpr Anesthesia Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326436353 PECOS PAC ID: 7416272927 Enrollment ID: O20200625003307 |
Entity Name | Anesthesia Stat Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467113357 PECOS PAC ID: 4385039346 Enrollment ID: O20220310000589 |
Mailing Address | Practice Location Address |
---|---|
Ms Kelly Renee Mangold, CRNA 3 Scarlet Oak Ct, Lake St Louis, MO 63367-2130 Ph: (312) 919-6286 | Ms Kelly Renee Mangold, CRNA 3 Scarlet Oak Ct, Lake St Louis, MO 63367-2130 Ph: (312) 919-6286 |