Active NPI
Tarina Marlene Mendes, MD
- Pediatric Endocrinology Physician
- Seneca, SC
National Provider Identifier
1205037702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Endocrinology Physician
- License
- 16207
- Practice address
- 207 Main St
Seneca, SC 29678-3245 - Phone
- (864) 882-2906
- NPI assigned
- May 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Endocrinology Physician | 2080P0205X | 16207 | SC | Primary |
Addresses
Primary practice location
207 Main St
Seneca, SC 29678-3245
Mailing address
701 Pine Creek CT
Seneca, SC 29672-2468
Phone (864) 885-9611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162077 | Medicaid | SC |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16207 | SC | MD | Pediatric Endocrinology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205037702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PINE CREEK CT",
"city": "SENECA",
"state": "SC",
"postal_code": "296722468",
"telephone_number": "864-885-9611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 MAIN ST",
"city": "SENECA",
"state": "SC",
"postal_code": "296783245",
"telephone_number": "864-882-2906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDES",
"first_name": "TARINA",
"middle_name": "MARLENE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "SC",
"license": "16207",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162077",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seneca, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.