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

Last updated

Nov 1, 2018By the provider in NPPES

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

• William Nisimblat Mdpa

  dba Alice Pediatric Clinic

  • 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 (Mi Casa Home Health Agency)
• Milestones Therapy Center
• Kimberley Michelle Mills, FNP-C

• Family Nurse Practitioner in Alice, TX
• Providers in Alice, TX by specialty
• 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.