Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1851074090 Individual Practitioner Female Practitioner

Mckenzie K Mangun , PA-C

Physician Assistant • Roanoke, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Mckenzie Mangun, PA-C is a certified Physician Assistant practicing in Roanoke, IL. With approximately 1 years of clinical experience since completing medical education in 2025, Mckenzie Mangun delivers high-quality medical care to the local community at 401 N MAIN ST.

Mckenzie Mangun is affiliated with Saint James Hospital and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

401 N Main St

Roanoke, IL 615617585

Telephone 3099232661
Fax 3099237628
Associated Practice Facility / Clinic
🏢 Saint James Hospital Facility NPI 1164138848

Medicare Profile & Education

Medical School

Other

Graduation Year

2025

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Roanoke, IL

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
1 Yrs -0.3 yrs vs City Avg
City Avg: 1.3 Yrs
State Avg: 11.7 Yrs
Regional Practice Density
3 Specialists

Practicing in Roanoke, IL (4958 Statewide)

Telehealth Adoption Rate
33.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mangun (1 Years) 1 Yrs
Roanoke Specialty Average (1.3 Years) 1.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-01-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085011710

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Saint James Hospital

401 N Main St, Roanoke, IL 615617585

Phone: 3099232661

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

25 Associated Practitioners
Rachel Anderson , APP

Nurse Practitioner - Family

NPI 1033937743
Michelle Stephens , APN

Nurse Practitioner

NPI 1053764365

Advanced Practice Nurse

Erica Svendsen , APRN, CNP

Nurse Practitioner - Family

NPI 1114704137

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Dr. Jennifer Stoller , DNP, PNP-PC

Nurse Practitioner - Pediatrics

NPI 1154035913

Doctor of Nursing Practice, PNPPC

Maddalena Davenport , APRN

Nurse Practitioner - Family

NPI 1154157808

Advanced Practice Registered Nurse

Hayley Wilson

Nurse Practitioner - Family

NPI 1174263206

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Business Mailing Address January 15, 2026

Registered at 401 N MAIN ST, ROANOKE, IL 615617585 (Tel: 3099232661)

📍
Updated Practice Location January 08, 2026

Registered at 401 N MAIN ST, ROANOKE, IL 615617585 (Tel: 3099232661)

📍
Updated Business Mailing Address January 08, 2026

Registered at 4361 N 1700 EAST RD, HEYWORTH, IL 617459050 (Tel: 2088608518)

👤
Provider Name / Credentials Updated January 08, 2026

Recorded as MCKENZIE MANGUN, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2026

Physician Assistant (License #085011710 in IL)

📍
Updated Practice Location September 24, 2025

Registered at 1505 E HAYDEN ST, POCATELLO, ID 832014161 (Tel: 2088608518)

📍
Updated Business Mailing Address September 24, 2025

Registered at 1505 E HAYDEN ST, POCATELLO, ID 832014161 (Tel: 2088608518)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 24, 2025

Physician Assistant

NPI Profile Active August 14, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location August 14, 2023

Registered at 921 S 8TH AVE STOP 8253, POCATELLO, ID 83209 (Tel: 2082824726)

📍
Updated Business Mailing Address August 14, 2023

Registered at 921 S 8TH AVE STOP 8253, POCATELLO, ID 83209 (Tel: 2082824726)

👤
Provider Name / Credentials Updated August 14, 2023

Recorded as MCKENZIE MANGUN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration August 14, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851074090
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 14, 2023
Last Update: January 15, 2026
Sole Proprietor: No

Mailing Address

401 N Main St

Roanoke, IL 615617585

Phone: 3099232661

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.