Individual provider Active NPI

Adriana Maryanna Mendoza, ATC

  • Athletic Trainer
  • Flat Rock, NC
National Provider Identifier
1316513401
Registry record updated May 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
6 Clem Rd
Flat Rock, NC 28731-5689
Phone
(828) 702-5575
NPI assigned
May 31, 2021
Last updated
May 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NU Primary

Addresses

Primary practice location

6 Clem Rd
Flat Rock, NC 28731-5689

Mailing address

PO Box 1125
Dana, NC 28724-1125
Phone (828) 702-5575

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": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1316513401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1125",
            "city": "DANA",
            "state": "NC",
            "postal_code": "287241125",
            "telephone_number": "828-702-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CLEM RD",
            "city": "FLAT ROCK",
            "state": "NC",
            "postal_code": "287315689",
            "telephone_number": "828-702-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "ADRIANA",
        "middle_name": "MARYANNA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-31",
        "last_updated": "2021-05-31",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flat Rock, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.