Active NPI
Abigail Jean Mendez
- Nurse Practitioner
- Mason, MI
National Provider Identifier
1013505478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704326681
- Practice address
- 247 Ives Rd
Mason, MI 48854-9240 - Phone
- (517) 604-0509
- NPI assigned
- Jan 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704326681 | MI | Primary |
Addresses
Primary practice location
247 Ives Rd
Mason, MI 48854-9240
Mailing address
247 Ives Rd
Mason, MI 48854-9240
Phone (517) 604-0509
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704326681 | MI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609459200000",
"number": "1013505478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 IVES RD",
"city": "MASON",
"state": "MI",
"postal_code": "488549240",
"telephone_number": "517-604-0509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "247 IVES RD",
"city": "MASON",
"state": "MI",
"postal_code": "488549240",
"telephone_number": "517-604-0509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ",
"first_name": "ABIGAIL",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-01",
"last_updated": "2021-01-01",
"certification_date": "2021-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704326681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mason, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.