NPIMap

Individual provider Active NPI

Kiru Korea Mendez, MD

  • Internal Medicine Physician
  • Rock Hill, SC
National Provider Identifier
1548399413
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2007-00432 Issued in NC
Practice address
222 South Herlong Ave.
Rock Hill, SC 29732
Phone
(803) 909-5937
NPI assigned
Mar 5, 2007
Last updated
Jan 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2007-00432 NC Primary
Internal Medicine Physician 207R00000X 35877 SC

Addresses

Primary practice location

222 South Herlong Ave.
Rock Hill, SC 29732

Mailing address

1370 W D St
North Wilkesboro, NC 28659-3506
Phone (803) 909-5937

Other identifiers 2

IdentifierTypeStateIssuer
N0043AMedicaidSC
5907178MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070828000771 NC Practitioner - Internal Medicine 0547352072
I20131023000652 SC Practitioner - Internal Medicine 0547352072 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007-00432NCMDInternal Medicine Physician
35877SCMDInternal Medicine Physician
200700NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System CurrentSince Jul 27, 2015 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Jan 9, 2020 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Apogee Medical Group South Carolina Internal Medicine CurrentSince May 1, 2017 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Jan 9, 2020 Accepting new patients
Greenville Health System CurrentSince Jul 27, 2015 Accepting new patients
GHS Partners in Health, Inc. Internal Medicine CurrentSince Oct 6, 2014 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Past Accepting new patients

Locations

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10110 Clemson Blvd
Seneca, SC 29678
Phone (864) 482-0500

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

301 Memorial Dr
Ste F
Seneca, SC 29672
Phone (864) 885-7758

Interoperability endpoints

  • Direct secure messaging: kmendez26920@directmcleodehealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1548399413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593506",
            "telephone_number": "803-909-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SOUTH HERLONG AVE.",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-909-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "KIRU",
        "middle_name": "KOREA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2007-00432",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "35877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0043A",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907178",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.