Tameki Lavette Mongo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5020818 Issued in NC

Practice address

12 N 5TH Ave
Wilmington, NC 28401-4537

Phone

(910) 765-1003

NPI assigned

Sep 9, 2024

Last updated

Sep 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Mobile Medical Group PAGroup PAC ID 8820528508, 7 clinicians

Triad Behavioral Resources PCGroup PAC ID 7911316435, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tameki.mongo.1@31553.direct.athenahealth.com

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.

• Southern Mobile Medical Group PA

  • General Practice Physician
  • Charlotte, NC
  • NPI 1730903675
  Medicare reassignment Care Compare group NPD
• Triad Behavioral Resources PC

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1336292556
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1770319691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 HUNTON FOREST DR NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280270084",
            "telephone_number": "704-491-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 5TH AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014537",
            "telephone_number": "910-765-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGO",
        "first_name": "TAMEKI",
        "middle_name": "LAVETTE",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monarc Wellness
• Monarch
• Jaclyn Moncada
• Robert Monds
• Zane Stallings Mondschein, PT, DPT, CSCS
• Vanessa Monk, LCSWA
• Joan Williamson Monroe, FNP
• Kathryn Jean Monroe, NP
• Adrienne Caroline Montero
• Alicia Denice Montgomery, LCAS

• Family Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.