KATHLEEN MENDHEIM (NPI# 1174873772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174873772 |
| Entity Type | Individual |
| Full Name | KATHLEEN MENDHEIM |
| Other Name | KATHLEEN C MILLER |
| Credential | CRNP |
| Practice Address |
287 Healthwest Dr Dothan AL 36303-2031 |
| Practice Telephone | 3347929500 |
| Practice Fax Number | 3347931815 |
| Mailing Telephone | 3347929500 |
| Mailing Fax Number | 3347931815 |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2017-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1-110354 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BC/BS AL | 511-57583 | 01 |
| AL | BC/BS AL | 511-57591 | 01 |
| AL | ALABAMA NURSING LICENSE | 1-110354 | 01 |
| Street Address |
287 HEALTHWEST DR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36303-2031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598732521 | Kenneth E. Roberts | Family Medicine | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2006-03-08 |
| 1871112235 | Brian Sherman | Registered Nurse | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2020-04-15 |
| 1619407764 | Casey Anderson | Pharmacist | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2017-06-12 |
| 1104359041 | Dothan Rx LLC | Pharmacy | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2017-04-07 |
| 1982141107 | Megan W Tillman | Nurse Practitioner | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2017-01-25 |
| 1013304468 | Jenna Oates | Nurse Practitioner | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2015-04-23 |
| 1881084986 | Whitney Hare Stoyak | Nurse Practitioner | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2015-01-27 |
| 1861827941 | Rachel W Tate | Nurse Practitioner | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2013-09-09 |
| 1902138456 | Allison Renee Mcallister | Nurse Practitioner | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2010-02-09 |
| 1619136413 | Jawaunna Talon Blackmon | Internal Medicine | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2008-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194205740 | Emblom & Vaughn, D.m.d., PC | Dentist | 318 Healthwest Dr., Dothan, AL 36303 | 2018-08-14 |
| 1164887907 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 118 Obrannan Park Drive, Dothan, AL 36303 | 2015-12-21 |
| 1245634245 | Api Counseling, LLC | Community/Behavioral Health | 1583 Montgomery Highway, Dothan, AL 36303 | 2014-10-20 |
| 1467792382 | Bolanle Boladale Akinduro | Home Health | 107 Hidden Glen Way, Dothan, AL 36303 | 2013-03-01 |
| 1104162114 | Al Dental PC | Dentist | 3400 Montgomery Highway, Dothan, AL 36303 | 2012-12-19 |
| 1659661874 | Juanita Titrud Heersink | Internal Medicine | 210 Westside Drive, Dothan, AL 36303 | 2011-04-08 |
| 1790918548 | Brandi Bradshaw Reeves | Counselor | 100 Westside Dr., Dothan, AK 36303 | 2009-08-27 |
| 1396917589 | Brian Davis | Physical Therapist | 3763 Ross Clark Circle, Dothan, AL 36303 | 2008-03-27 |
| 1558544544 | Healthwest Dental Associates PC | Dentist | 502 Healthwest Drive, Dothan, AL 36303 | 2007-12-12 |
| 1770644775 | Christine Carroll Fain | Occupational Therapist | 3763 Ross Clark Cir Ste 1, Alacare Home Health, Dothan, AL 36303 | 2006-12-13 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568095446 | Marathon Health LLC | Nurse Practitioner | 131 Cliff Rd, Dothan, AL 36303-5415 | 2020-02-19 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1902396286 | Genevieve Patricia Lewellyn | Nurse Practitioner | 1184 Upton Rd, Dothan, AL 36305-5134 | 2018-05-13 |
| 1073979886 | Sydney Stevens Weber | Nurse Practitioner | 1052 Ross Clark Cir, Dothan, AL 36303-5425 | 2016-01-08 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1013310143 | Samantha Poole Carter | Nurse Practitioner | 4300 W Main St Ste 15, Dothan, AL 36305-1058 | 2014-10-03 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1144469438 | Houston County Healthcare Authority | Nurse Practitioner | 1806 Fairview Ave Ste A, Dothan, AL 36301-3026 | 2009-02-11 |
| 1851430383 | Robert Michael Ortiz | Nurse Practitioner | 1118 Ross Clark Cir Ste 303, Dothan, AL 36301-3002 | 2007-02-05 |
| 1841309648 | Malissa Harkleroad Williams | Nurse Practitioner | 3753 Ross Clark Cir, Suite 4, Dothan, AL 36303-2295 | 2006-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.