Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Scott Ryan Mangum, PA-C

Individual provider Medical Physician Assistant · NPI 1043180730

Scott Ryan Mangum, PA-C is a Physician Assistant in Blackfoot, Idaho. Graduated from University of Washington School of Medicine in 2025, 1 year ago. Practices with Bmh Inc, a 136-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
1
Trained at
University of Washington School of Medicine
Licensed in
ID
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

98 Poplar St
Blackfoot, ID 83221-1799
Phone: (208) 785-4100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 7371782 (ID)

Record details

NPI number1043180730
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 7, 2025
Last updated in NPPESNovember 7, 2025
Certification dateNovember 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Group practice Bmh Inc — 136 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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