Individual provider Active NPI

Sharon Lee Mendenhall, LCSW, CCBT, DAPA

  • Clinical Social Worker
  • Queen Creek, AZ
National Provider Identifier
1174718019
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11568 Issued in AZ
Practice address
301 E Combs Rd
Queen Creek, AZ 85240-9164
Phone
(480) 987-5300
Fax
(480) 987-5009
NPI assigned
Sep 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11568 AZ Primary

Addresses

Primary practice location

301 E Combs Rd
Queen Creek, AZ 85240-9164

Mailing address

301 E Combs Rd
Queen Creek, AZ 85240-9164
Phone (480) 987-5300

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Cardiology Consultants, PC Past Accepting new patients
J.O. Combs Unified School District #44 Past Accepting new patients
Tri-City Cardiology Consultants, PC PastSince Jul 11, 2011 Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1174718019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E COMBS RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852409164",
            "telephone_number": "480-987-5300",
            "fax_number": "480-987-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E COMBS RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852409164",
            "telephone_number": "480-987-5300",
            "fax_number": "480-987-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "SHARON",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, CCBT, DAPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "11568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.