Active NPI
Haldane Mendoza Go, PT
- Physical Therapist
- Crown Point, IN
National Provider Identifier
1881880268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05008082A
- Practice address
- 203 Franciscan Dr
Crown Point, IN 46307-4802 - Phone
- (219) 661-5172
- NPI assigned
- Sep 19, 2007
- Last updated
- Sep 19, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05008082A | IN | Primary |
Addresses
Primary practice location
203 Franciscan Dr
Crown Point, IN 46307-4802
Mailing address
10345 Price St
Crown Point, IN 46307-7608
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05008082A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1881880268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10345 PRICE ST",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463077608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 FRANCISCAN DR",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463074802",
"telephone_number": "219-661-5172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GO",
"first_name": "HALDANE",
"middle_name": "MENDOZA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05008082A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.