Individual provider Active NPI

Carla D Mendieta, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1407522303
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
215227 Issued in AR
Practice address
1000 S Waldron Rd
Fort Smith, AR 72903-2550
Phone
(479) 221-9922
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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 215227 AR Primary

Addresses

Primary practice location

1000 S Waldron Rd
Fort Smith, AR 72903-2550

Mailing address

1000 S Waldron Rd
Fort Smith, AR 72903-2550
Phone (479) 221-9922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20220106000097 AR Practitioner - Nurse Practitioner 3173914876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 S Waldron Rd
Fort Smith, AR 72903-2550
Phone (479) 221-9922

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215227ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 18, 2021 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 18, 2021 Accepting new patients

Locations

1000 S Waldron Rd
Fort Smith, AR 72903
Phone (479) 221-9922

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

Interoperability endpoints

  • Direct secure messaging: cmendieta803653@directc.mercy.net

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 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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1407522303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032550",
            "telephone_number": "479-221-9922",
            "fax_number": "479-221-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032550",
            "telephone_number": "479-221-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIETA",
        "first_name": "CARLA",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "215227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.