Active NPI
Troy Mendenhall
- Athletic Trainer
- Great Mills, MD
National Provider Identifier
1295272250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT6825
- Practice address
- 45444 Blue Flax Way
Great Mills, MD 20634-3466 - Phone
- (240) 434-2953
- NPI assigned
- Jan 27, 2017
- Last updated
- Jan 27, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT6825 | TX | Primary |
Addresses
Primary practice location
45444 Blue Flax Way
Great Mills, MD 20634-3466
Mailing address
45444 Blue Flax Way
Great Mills, MD 20634-3466
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT6825 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485475200000",
"number": "1295272250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45444 BLUE FLAX WAY",
"city": "GREAT MILLS",
"state": "MD",
"postal_code": "206343466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45444 BLUE FLAX WAY",
"city": "GREAT MILLS",
"state": "MD",
"postal_code": "206343466",
"telephone_number": "240-434-2953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDENHALL",
"first_name": "TROY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-27",
"last_updated": "2017-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT6825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Mills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.