Tara Mendietta, FNPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP139592 Issued in TX

Practice address

305 E 3Rd St
Alice, TX 78332-4705

Phone

(361) 664-9353

Fax

(361) 668-1630

NPI assigned

Nov 1, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• William Nisimblat Mdpa

  • Pediatrics Physician
  • Alice, TX
  • NPI 1477646271
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1467929083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783330289",
            "telephone_number": "361-664-9353",
            "fax_number": "361-668-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 3RD ST",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783324705",
            "telephone_number": "361-664-9353",
            "fax_number": "361-668-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIETTA",
        "first_name": "TARA",
        "credential": "FNPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Jean McLaughlin-Camacho, DPT
• Daniella Medellin
• Medical Imaging Diagnostic Associates
• Medquick Supplies LLC
• Erika Ann Mendez, PH.D., LPC
• Ricardo Elias Mendiondo Jr., FNP-C
• Mi Casa Hospice, L.L.C
• Mi Casa Nursing Services Home Health LLC
• Milestones Therapy Center
• Kimberley Michelle Mills, FNP-C

• All providers in Alice, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.