Active NPI
Mary J Mendoza, CNP
- Women's Health Nurse Practitioner
- Roswell, NM
National Provider Identifier
1699803890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- CNP00410
- Practice address
- 200 E Chisum St
Roswell, NM 88203-5406 - Phone
- (575) 347-2409
- Fax
- (575) 624-6170
- NPI assigned
- Mar 1, 2007
- Last updated
- Aug 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | CNP00410 | NM | Primary |
Addresses
Primary practice location
200 E Chisum St
Roswell, NM 88203-5406
Mailing address
200 E Chisum St
Roswell, NM 88203-5406
Phone (575) 347-2409
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP00410 | NM | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408406400000",
"number": "1699803890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E CHISUM ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882035406",
"telephone_number": "575-347-2409",
"fax_number": "575-624-6170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E CHISUM ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882035406",
"telephone_number": "575-347-2409",
"fax_number": "575-624-6170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "MARY",
"middle_name": "J",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2014-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "NM",
"license": "CNP00410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.