Individual provider Active NPI

Vishesh Mehra, DO

  • Family Medicine Physician
  • Fernandina Beach, FL
National Provider Identifier
1548958812
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS23959 Issued in FL
Practice address
1210 Vintage Way
Fernandina Beach, FL 32034-0299
Phone
(904) 261-0922
Fax
(904) 390-7477
NPI assigned
Apr 25, 2023
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OL61425321 WA
Family Medicine Physician 207Q00000X OL61425321 WA
Family Medicine Physician 207Q00000X OS23959 FL Primary

Addresses

Primary practice location

1210 Vintage Way
Fernandina Beach, FL 32034-0299

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802002604 WA Order and Referring Only - Family PracticePractitioner - Family Practice 0042671398

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS23959FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1548958812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 VINTAGE WAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320340299",
            "telephone_number": "904-261-0922",
            "fax_number": "904-390-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRA",
        "first_name": "VISHESH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-25",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "OL61425321",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL61425321",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS23959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.