Individual provider Active NPI

Seth M Mendenhall, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • West Burlington, IA
National Provider Identifier
1427793710
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G170108 Issued in IA
Practice address
1401 W Agency Rd
West Burlington, IA 52655-1643
Phone
(319) 768-4191
NPI assigned
May 1, 2022
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G170108 IA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1401 W Agency Rd
West Burlington, IA 52655-1643

Mailing address

508 W Morningside Dr
Burlington, IA 52601-1679
Phone (217) 257-2215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220902000641 IA Practitioner - Nurse Practitioner 4688058043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 S Gear Ave
West Burlignton, IA 52655-1679
Phone (319) 768-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G170108IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. Single Specialty CurrentSince Sep 12, 2022 Accepting new patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Sep 12, 2022 Accepting new patients

Locations

5409 Avenue O
Ste 101
Fort Madison, IA 52627
Phone (319) 372-6530

5409 Avenue O
Ste 125
Fort Madison, IA 52627
Phone (319) 376-1130

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

1223 S Gear Ave
Ste 254
West Burlington, IA 52655

1401 W Agency Rd
West Burlington, IA 52655
Phone (319) 768-4100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1651363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1427793710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 W MORNINGSIDE DR",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526011679",
            "telephone_number": "217-257-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551643",
            "telephone_number": "319-768-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "SETH",
        "middle_name": "M",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-01",
        "last_updated": "2023-01-12",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G170108",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.