DR. MENDOZA'S PEDIATRIC AND ADOLSCENT NPI 1295908101

Pediatrics (Adolescent Medicine) in Jackson, KY

NPI 1295908101 Organization Pediatrics Adolescent Medicine

NPI Profile for DR. MENDOZA'S PEDIATRIC AND ADOLSCENT

Dr. Mendoza's Pediatric And Adolscent is a pediatrician established in Jackson, Kentucky specializing in pediatrics (adolescent medicine) . The NPI number of Dr. Mendoza's Pediatric And Adolscent is 1295908101 and was assigned on April 2008. The practitioner's primary taxonomy code is 2080A0000X with license number 33465 (KY). The provider is registered as an organization and their NPI record was last updated 8 years ago. Dr. Mendoza's Pediatric And Adolscent operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Edgar Allen Mendoza Md (Owner)

A pediatrician like Dr. Mendoza's Pediatric And Adolscent is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

NPI

1295908101

Provider NameDR. MENDOZA'S PEDIATRIC AND ADOLSCENT
Provider Location Address424 JETT DR JACKSON, KY 41339
Provider Mailing AddressPO BOX 790 JACKSON, KY 41339
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-11-2008
Last Update Date07-10-2014


Primary Taxonomy

Taxonomy Code2080A0000X
ClassificationPediatrics
TypeAllopathic & Osteopathic Physicians
SpecializationAdolescent Medicine
License No.33465
License StateKY
Taxonomy DescriptionA pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

Business Address

DR. MENDOZA'S PEDIATRIC AND ADOLSCENT
424 JETT DR
JACKSON, KY
ZIP 41339
Phone: (606) 693-4800
Fax: (606) 693-4825

Get Directions


Mailing Address

DR. MENDOZA'S PEDIATRIC AND ADOLSCENT
PO BOX 790
JACKSON, KY
ZIP 41339
Phone: (606) 693-4800
Fax: (606) 693-4825



Authorized Official

Authorized Official Name EDGAR ALLEN MENDOZA MD
Authorized Official TitleOWNER
Authorized Official Phone(606) 693-4800

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
31000979MEDICAID (05)KY

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1295908101
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221851801610
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 8 + 5 + 1 + 8 + 0 + 1 + 6 + 1 + 0 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1295908101 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003815390DR. GEORGE EDWARD BURNETTE MD
Individual
Family Medicine424 JETT DR
JACKSON, KY 41339
(606) 666-6000
1992827927KENTUCKY RIVER PHYSICIAN CORPORATION
Organization
Clinic/Center (Rural Health)424 JETT DR
JACKSON, KY 41339
(606) 666-6600
1164722807JACKSON PHYSICIAN CORP
Organization
Durable Medical Equipment & Medical Supplies424 JETT DR
JACKSON, KY 41339
(606) 666-5354
1083145866 REBECCA MAE HOLBROOK-WATKINS APRN
Individual
Nurse Practitioner (Family)424 JETT DR
JACKSON, KY 41339
(606) 666-6600
1841234671JACKSON PHYSICIAN CORP
Organization
General Practice424 JETT DR
JACKSON, KY 41339
(066) 936-4830
1912518978JACKSON HOSPITAL CORPORATION
Organization
Clinic/Center (Rural Health)424 JETT DR
JACKSON, KY 41339
(606) 666-6600

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Mendoza's Pediatric And Adolscent is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.