Active NPI
Tania Mendoza
- Community Health Worker
- Corvallis, OR
National Provider Identifier
1235892233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 530 NW 27TH St
Corvallis, OR 97330-5298 - Phone
- (541) 766-6835
- NPI assigned
- Oct 16, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | OR | Primary |
Addresses
Primary practice location
530 NW 27TH St
Corvallis, OR 97330-5298
Mailing address
2406 NW Jackson Ave Apt 3
Corvallis, OR 97330-5389
Phone (541) 571-8736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IHN | Other | OR | INTERCOMMUNITY HEALTH PLAN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Corvallis |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634342400000",
"number": "1235892233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2406 NW JACKSON AVE APT 3",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305389",
"telephone_number": "541-571-8736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 NW 27TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305298",
"telephone_number": "541-766-6835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "TANIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-16",
"last_updated": "2021-10-16",
"certification_date": "2021-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERCOMMUNITY HEALTH PLAN",
"identifier": "IHN",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Corvallis",
"affiliation": "N",
"address_1": "530 NW 27th St",
"city": "Corvallis",
"state": "OR",
"country_code": "US",
"postal_code": "973305298",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.