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

Shane C Mangrum, MD

Individual provider Rehabilitation Practitioner · NPI 1891796595

Shane C Mangrum, MD is a Rehabilitation Practitioner in Atlanta, Georgia. Licensed in Georgia and Idaho. Registered with an NPI since 2005.

Licensed in
GA, ID
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1150 Hammond Dr Ste 400
Atlanta, GA 30328-5334
Phone: (404) 256-2633
Fax: (404) 255-6532
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Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X · Licence 73026 (GA)
Rehabilitation Practitioner Taxonomy 225400000X · Licence M9189 (ID)

Record details

NPI number1891796595
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 3, 2005
Last updated in NPPESFebruary 12, 2026
Mailing address1150 Hammond Dr, Suite 400, Atlanta, GA 30328-5334

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