Active NPI
Jonathan Mendonsa
- Pharmacist
- North Chesterfield, VA
National Provider Identifier
1154723047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202212420
- Practice address
- 4201 Meadowdale Blvd
North Chesterfield, VA 23234-5465 - Phone
- (804) 271-8100
- NPI assigned
- Sep 23, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202212420 | VA | Primary |
Addresses
Primary practice location
4201 Meadowdale Blvd
North Chesterfield, VA 23234-5465
Mailing address
4201 Meadowdale Blvd
North Chesterfield, VA 23234-5465
Phone (804) 271-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0202212420 | Other | VA | BOARD OF PHARMACY LICENSE NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202212420 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
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- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1154723047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 MEADOWDALE BLVD",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232345465",
"telephone_number": "804-271-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 MEADOWDALE BLVD",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232345465",
"telephone_number": "804-271-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDONSA",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-23",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202212420",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY LICENSE NUMBER",
"identifier": "0202212420",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Chesterfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.