Active NPI
Mildred M Mensendiek, PT
- Physical Therapist
- Bloomington, IN
National Provider Identifier
1962798918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05003079A
- Practice address
- 4200 S Falcon Dr
Bloomington, IN 47403-9048 - Phone
- (812) 340-5007
- NPI assigned
- Jun 28, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05003079A | IN | Primary |
Addresses
Primary practice location
4200 S Falcon Dr
Bloomington, IN 47403-9048
Mailing address
4200 S Falcon Dr
Bloomington, IN 47403-9048
Phone (812) 340-5007
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05003079A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacycare Home Health, LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Bloomington, IN
- NPI 1083556963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1962798918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 S FALCON DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474039048",
"telephone_number": "812-340-5007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 S FALCON DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474039048",
"telephone_number": "812-340-5007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENSENDIEK",
"first_name": "MILDRED",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05003079A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.