Individual provider Active NPI

Brian Mendenhall, MD

  • Emergency Medicine Physician
  • Longview, TX
National Provider Identifier
1306835442
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
K4955 Issued in TX
Practice address
700 E Marshall Ave
Longview, TX 75601-5580
Phone
(903) 315-2000
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X K4955 TX
Emergency Medicine Physician 207P00000X K4955 TX Primary

Addresses

Primary practice location

700 E Marshall Ave
Longview, TX 75601-5580

Mailing address

303 W Loop 281, Ste 110, Box 321
Longview, TX 75605-4444
Phone (903) 757-0351

Other identifiers 1

IdentifierTypeStateIssuer
116408904MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070726000171 TX Practitioner - Emergency MedicinePractitioner - General Practice 6507967148 Reassigns benefits to 4 organizations
Practice locations: Longview, TX

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Practice
Education
University of Texas Medical School at San Antonio, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K4955TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Texas Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Acute Care Specialists Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients
Van Family Medical PastSince Mar 27, 2022 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

2000 S Palestine St
Athens, TX 75751
Phone (903) 675-2216

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

409 Cottage Rd
Carthage, TX 75633
Phone (903) 693-3841

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

300 Wilson St
Henderson, TX 75652
Phone (903) 655-6536

1612 S Henderson Blvd
Kilgore, TX 75662
Phone (903) 983-2492

120 E Loop 281
Longview, TX 75605
Phone (903) 500-7321

323 E Hawkins Pkwy
Longview, TX 75605
Phone (903) 315-2000

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

4920 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 568-3441

2600 E Pflugerville Pkwy
Ste 100
Pflugerville, TX 78660
Phone (512) 654-6100

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

1975 Alpha Dr
#100
Rockwall, TX 75087
Phone (214) 294-6200

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

Interoperability endpoints

  • Direct secure messaging: bmendenhall839210@ahs.direct-ci.com

Organizations & group practices 5

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 1

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1306835442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W LOOP 281, STE 110, BOX 321",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054444",
            "telephone_number": "903-757-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "K4955",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K4955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116408904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.