Individual provider Active NPI

Jane M Kerner-Mendoza, CNS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Tucker, GA
National Provider Identifier
1912009952
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
RN045574 Issued in GA
Practice address
200 Crescent Centre Parkway
Department of Behavioral Health
Tucker, GA 33084
Phone
(770) 496-3609
Fax
(770) 496-3708
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X RN045574 GA Primary

Addresses

Primary practice location

200 Crescent Centre Parkway
Department of Behavioral Health
Tucker, GA 33084

Mailing address

3495 Piedmont Road NE
Nine Piedmont Center
Atlanta, GA 30305-1736
Phone (404) 364-7000

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
Credentials
Certified Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912009952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051736",
            "telephone_number": "404-364-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CRESCENT CENTRE PARKWAY",
            "address_2": "DEPARTMENT OF BEHAVIORAL HEALTH",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "33084",
            "telephone_number": "770-496-3609",
            "fax_number": "770-496-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER-MENDOZA",
        "first_name": "JANE",
        "middle_name": "M",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN045574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.