Individual provider Active NPI

John Robert Mehall, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colorado Springs, CO
National Provider Identifier
1164635009
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
45535 Issued in CO
Practice address
2222 N. Nevada Avenue
Suite 5011
Colorado Springs, CO 80907
Phone
(719) 776-7600
Fax
(719) 473-3553
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 45535 CO Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X K7453 TX

Addresses

Primary practice location

2222 N. Nevada Avenue
Suite 5011
Colorado Springs, CO 80907

Mailing address

2222 N. Nevada Avenue
Suite 5011
Colorado Springs, CO 80907
Phone (719) 776-7600

Other identifiers 1

IdentifierTypeStateIssuer
19150873MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000190 CO Practitioner - Thoracic Surgery 2466449517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45535COMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
K7453TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Hospital Association Current Accepting new patients
Valley View Hospital Association CurrentSince Sep 18, 2018 Accepting new patients
Valley View Hospital Association CurrentSince Sep 18, 2018 Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients
Vascucare PC PastSince Nov 11, 2014 Accepting new patients
Nazareth Hospital Past Accepting new patients

Locations

2222 N Nevada Ave
Ste 5011
Colorado Springs, CO 80907
Phone (719) 776-7600

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

Interoperability endpoints

  • Direct secure messaging: vvh_him@direct.vvh.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1164635009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N. NEVADA AVENUE",
            "address_2": "SUITE 5011",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-776-7600",
            "fax_number": "719-473-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N. NEVADA AVENUE",
            "address_2": "SUITE 5011",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-776-7600",
            "fax_number": "719-473-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHALL",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CO",
            "license": "45535",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "K7453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19150873",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.