Active NPI
Mohammed Mendhi, MD
- Family Medicine Physician
- Fleming Island, FL
National Provider Identifier
1487621736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME44930
- Practice address
- 4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822 - Phone
- (904) 269-4559
- Fax
- (904) 269-4597
- NPI assigned
- Mar 7, 2006
- Last updated
- Dec 12, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME44930 | FL | Primary |
Addresses
Primary practice location
4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822
Mailing address
581 Gulfstream TRL E
Orange Park, FL 32073-5851
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME44930 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1487621736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "581 GULFSTREAM TRL E",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4565 US HIGHWAY 17 STE 106",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320034822",
"telephone_number": "904-269-4559",
"fax_number": "904-269-4597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDHI",
"first_name": "MOHAMMED",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME44930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fleming Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.