Individual provider Active NPI

Tucker Steven Mendonca, FNP

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1609701929
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32314 Issued in SC
Practice address
2085 Henry Tecklenburg Dr
Charleston, SC 29414-7710
Phone
(843) 577-6957
Fax
(843) 577-6523
NPI assigned
Jun 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32314 SC Primary
Oncology Registered Nurse 163WX0200X RN10002778 MA

Addresses

Primary practice location

2085 Henry Tecklenburg Dr
Charleston, SC 29414-7710

Mailing address

PO Box 632509
Cincinnati, OH 45263-2509
Phone (888) 472-0043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8536 Palmetto Commerce Pkwy
Suite 501
Ladson, SC 29456-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1609701929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632509",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632509",
            "telephone_number": "888-472-0043",
            "fax_number": "513-653-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147710",
            "telephone_number": "843-577-6957",
            "fax_number": "843-577-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDONCA",
        "first_name": "TUCKER",
        "middle_name": "STEVEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "32314",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "MA",
            "license": "RN10002778",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.