Individual provider Active NPI

Sarah Marie Mendenhall, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1124471974
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A004777 Issued in AR
Practice address
6601 W 12TH St
Little Rock, AR 72204-1513
Phone
(501) 666-8686
Fax
(501) 666-6830
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61007036 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 132342 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X A004777 AR Primary

Addresses

Primary practice location

6601 W 12TH St
Little Rock, AR 72204-1513

Mailing address

PO Box 251970
Little Rock, AR 72225-1970
Phone (501) 666-8686

Other practice location 1

9330 59th Ave SW
Lakewood, WA 98499-2858
Phone (253) 581-7020

Other practice location 2

1545 Harbeck Rd
Grants Pass, OR 97527-5605
Phone (541) 479-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021003020 OR Practitioner - Nurse Practitioner 7315373552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Options for Southern OregonGroup PAC ID 0941202006, 70 clinicians

Practice addresses (Care Compare)

1545 Harbeck Rd
Grants Pass, OR 97527-5605
Phone (541) 476-2373

Hospital & facility affiliations

  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A004777ARMDPsychiatric/Mental Health Nurse Practitioner
132342ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Options for Southern Oregon CurrentSince May 26, 2020 Accepting new patients
Options for Southern Oregon Current Accepting new patients

Locations

1215 SW G St
Grants Pass, OR 97526
Phone (541) 244-4109

1545 Harbeck Rd
Grants Pass, OR 97527
Phone (541) 479-2371

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1124471974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251970",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251970",
            "telephone_number": "501-666-8686",
            "fax_number": "501-630-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041513",
            "telephone_number": "501-666-8686",
            "fax_number": "501-666-6830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 59th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992858",
            "country_code": "US",
            "telephone_number": "253-581-7020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1545 Harbeck Rd",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275605",
            "country_code": "US",
            "telephone_number": "541-479-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61007036",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "132342",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A004777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.