Individual provider Active NPI

Allison Mendenhall, PA-C

  • Physician Assistant
  • Troy, OH
National Provider Identifier
1548545544
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003594 Issued in OH
Practice address
998 S Dorset Rd
Suite 301
Troy, OH 45373-4753
Phone
(937) 339-5441
NPI assigned
Oct 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106254 FL
Physician Assistant 363A00000X 50.003594 OH Primary

Addresses

Primary practice location

998 S Dorset Rd
Suite 301
Troy, OH 45373-4753

Mailing address

998 S Dorset Rd
Suite 301
Troy, OH 45373-4753
Phone (937) 339-5441

Other identifiers 1

IdentifierTypeStateIssuer
0076383MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111122000570 FL Practitioner - Physician Assistant 5597939835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone (386) 238-3200

740 Dunlawton Ave
Suite 200
Port Orange, FL 32127-4240
Phone (386) 763-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003594OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Oct 10, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1548545544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 S DORSET RD",
            "address_2": "SUITE 301",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453734753",
            "telephone_number": "937-339-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 S DORSET RD",
            "address_2": "SUITE 301",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453734753",
            "telephone_number": "937-339-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "ALLISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106254",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076383",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

Verify at the official NPI Registry.