Individual provider Active NPI

Amanda Mendoza, NP

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1245733989
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN243409 Issued in GA
Practice address
4 E Jackson Blvd
Savannah, GA 31405-5810
Phone
(912) 355-1010
Fax
(912) 351-0589
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN243409 GA Primary

Addresses

Primary practice location

4 E Jackson Blvd
Savannah, GA 31405-5810

Mailing address

4 E Jackson Blvd
Savannah, GA 31405-5810
Phone (912) 355-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180802003469 GA Practitioner - Nurse Practitioner 5597013839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4 E Jackson Blvd
Savannah, GA 31405-5810
Phone (912) 355-1010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN243409GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Neurological Institute of Savannah & Center for Spine P C Current Accepting new patients
The Neurological Institute of Savannah & Center for Spine, PC CurrentSince Apr 30, 2018 Accepting new patients

Locations

4 E Jackson Blvd
Savannah, GA 31405

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1245733989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 E JACKSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055810",
            "telephone_number": "912-355-1010",
            "fax_number": "912-351-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E JACKSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055810",
            "telephone_number": "912-355-1010",
            "fax_number": "912-351-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN243409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.