Jeromy Ron Mendenhall, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1131 Issued in NV

Practice address

1301 Bertha Howe Ave
Suite 1
Mesquite, NV 89027-7502

Phone

(435) 628-9393

Fax

(435) 628-9382

NPI assigned

Jul 15, 2008

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1275714677

  NV

  Medicare reassignment
• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Reno, NV
  • NPI 1487996054
  NPD
• David J Barth P.C.

  • Surgical Physician Assistant
  • Las Vegas, NV
  • NPI 1104162643
  NPD (past)
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD (past)

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1881858280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 SAINT ROSE PKWY 320",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523508",
            "telephone_number": "702-997-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BERTHA HOWE AVE",
            "address_2": "SUITE 1",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890277502",
            "telephone_number": "435-628-9393",
            "fax_number": "435-628-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "JEROMY",
        "middle_name": "RON",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7106674-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1131",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1131",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "7106674-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly McKenzie
• Marcella Aremea Medlin
• Rita Maria Mejia-Braeckevelt, DO
• Kimberly Anne Melle
• Kyle D. Memmott, MPT
• Mercy Air Service, Inc.
• Mesa Ridge, LLC (Mesa Ridge Pharmacy)
• Mesa Ridge, LLC (Mesa Ridge Pharmacy)
• Mesa View Home Care
• Mesa View Home Care, LLC

• Physician Assistant in Mesquite, NV
• Providers in Mesquite, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.