Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Blackhawk Mangum, LLC

Primary Care Clinic/Center in Hollis, OK · enumerated 2008 · authorized official Shana Davenport, Insurance Credentialing Supervisor.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1366611824

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Registry record

Entity type Organization (Type 2)

Legal business name Blackhawk Mangum, LLC

Other name <Unavail>

Practice address 513 East Chestnut, Hollis, OK, 73550

Phone (580) 688-3314

Fax (580) 688-9530

Enumeration date Feb 28, 2008

Last updated in NPPES Jul 23, 2008

Taxonomy & classification

261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities · License 2208 (OK) Primary

Authorized official

Name Shana Davenport

Title Insurance Credentialing Supervisor

Phone (512) 681-3460

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where is Blackhawk Mangum, LLC located?

The practice location on file with NPPES is in Hollis, OK.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-07-23. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-07-23.