Active NPI
Jerald Austin Mejia
- Electroneurodiagnostic Specialist/Technologist
- Addison, TX
National Provider Identifier
1275277600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- Practice address
- 5080 Spectrum Dr
Addison, TX 75001-4648 - Phone
- (844) 676-9374
- NPI assigned
- Apr 22, 2022
- Last updated
- Jun 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | Primary | ||
| Behavior Technician | 106S00000X | CA |
Addresses
Primary practice location
5080 Spectrum Dr
Addison, TX 75001-4648
Mailing address
3333 Concours St
Suite 4102
Ontario, CA 91764-6564
Phone (909) 240-1764
Other practice location 1
3333 Concours St
Suite 4102
Ontario, CA 91764-6564
Phone (909) 240-1764
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/A |
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": "1650585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1275277600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 CONCOURS ST",
"address_2": "SUITE 4102",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917646564",
"telephone_number": "909-240-1764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DR",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014648",
"telephone_number": "844-676-9374"
}
],
"practiceLocations": [
{
"address_1": "3333 Concours St",
"address_2": "Suite 4102",
"address_purpose": "LOCATION",
"city": "Ontario",
"state": "CA",
"postal_code": "917646564",
"country_code": "US",
"telephone_number": "909-240-1764",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEJIA",
"first_name": "JERALD",
"middle_name": "AUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-22",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"address_1": "3333 Concours",
"city": "Ontario",
"state": "CA",
"country_code": "US",
"postal_code": "917644875",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Addison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.