DR. CIRIACO ADA MENDOZA (NPI# 1376584508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376584508 |
| Entity Type | Individual |
| Full Name | DR. CIRIACO ADA MENDOZA |
| Credential | M.D. |
| Practice Address |
122 12th Street Ext Princeton WV 24740-2352 |
| Mailing Address |
Po Box 634715 Cincinnati OH 45263-0001 |
| Practice Telephone | 3044877000 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 13884 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BLUE CROSS | 000699368 | 01 |
| WV | 0052156-000 | 05 | |
| WV | WORKERS COMP | 1044421 | 01 |
| WV | MEDICARE RAILROAD | P00048451 | 01 |
| Street Address |
122 12TH STREET EXT |
| City | PRINCETON |
| State | WV |
| Zip Code | 24740-2352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215936091 | Carlos Fernandez Delara | Pathology | 122 12th Street Ext, Princeton, WV 24740-2352 | 2005-07-14 |
| 1104286913 | Jessica Moses | Speech-Language Pathologist | 122 12th Street Ext, Princeton, WV 24740-2352 | 2016-03-07 |
| 1669851200 | Darrell W Shrewsbury | Nurse Practitioner | 122 12th Street Ext, Princeton, WV 24740-2352 | 2015-05-28 |
| 1922365089 | Ges Hospitalist Services Inc | Family Medicine | 122 12th Street Ext, Princeton, WV 24740-2352 | 2012-04-13 |
| 1972891265 | Misty Dillow | Nurse Practitioner | 122 12th Street Ext, Princeton, WV 24740-2352 | 2011-07-20 |
| 1558594598 | Heather Leigh Harris | Physician Assistant | 122 12th Street Ext, Princeton, WV 24740-2352 | 2009-08-25 |
| 1598921884 | Margaret L Choate | Nurse Practitioner | 122 12th Street Ext, Princeton, WV 24740-2352 | 2008-08-06 |
| 1992971253 | Melissa Dawn Lilly | Physician Assistant | 122 12th Street Ext, Princeton, WV 24740-2352 | 2008-05-06 |
| 1235311044 | Princeton Community Hospital Association, Inc. | Psychiatric Unit | 122 12th Street Ext, Princeton, WV 24740-2352 | 2007-12-04 |
| 1447458609 | Brandon L Fain | Physician Assistant | 122 12th Street Ext, Princeton, WV 24740-2352 | 2007-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658632 | New Beginnings Therapy Services, LLC | Community/Behavioral Health | 616 Harrison Street, Princeton, WV 24740 | 2020-10-27 |
| 1215536222 | Right At Home | Home Health | 313 Locus St, Princeton, WV 24740 | 2020-10-21 |
| 1881208098 | Robin Lane | Technician | 174 Tea Kettle Road, Princeton, WV 24740 | 2020-09-04 |
| 1134739824 | Nona Arthur | Technician | 708 Bluefiled Ave, Princeton, WV 24740 | 2020-08-06 |
| 1851909014 | Tina B Altizer | Speech-Language Pathologist | 120 12th Street, Princeton, WV 24740 | 2020-07-14 |
| 1245712504 | Tracy Jean Mitchell | Speech-Language Pathologist | 1200 Mercer St, Princeton, WV 24740 | 2018-09-04 |
| 1700305240 | Tina Six | Registered Nurse | 1403 Honaker Avenue, Princeton, WV 24740 | 2017-09-15 |
| 1013449172 | Karin Cappa | Pharmacist | 669 Cornfield Rd, Princeton, WV 24740 | 2017-03-29 |
| 1942661723 | Virginia Chryssikos | Social Worker | 3016 E Cumberland Road, Bluestone Family Practice, Bluefield, WV 24740 | 2016-03-08 |
| 1477939460 | Kathy Diane Wyrick | Counselor | 220 South Walker Street, Princeton, WV 24740 | 2015-08-03 |
| Find all providers in zip 24740 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790170835 | Chad Williams | Emergency Medicine | 177 Highpoint Ln, Princeton, WV 24739-6454 | 2015-04-06 |
| 1326351461 | Medexpress Urgent Care, Inc - West Virginia | Emergency Medicine | 277 Greasy Ridge Road, Princeton, WV 24740-6900 | 2010-07-19 |
| 1447372867 | Mark Alexander Spitzer | Emergency Medicine | 2767 Clover Dew Dairy Rd, Princeton, WV 24740-7548 | 2007-04-05 |
| 1578698163 | Charles John Mchugh | Emergency Medicine | 4 Charlton St, Princeton, NJ 08540-5232 | 2007-02-22 |
| 1366503088 | Dennis P Price | Emergency Medicine | 59 Coppervail Ct, Princeton, NJ 08540-7714 | 2006-12-13 |
| 1922114677 | Paul H Bonucci | Emergency Medicine | 2128 N Main St, Princeton, IL 61356-9728 | 2006-08-22 |
| 1316971807 | J. Eric Dario Castro | Emergency Medicine | 530 Park Ave East, Dept of Emergency Medicine, Princeton, IL 61356 | 2006-07-10 |
| 1952333494 | Nara C Shin | Emergency Medicine | Washington Road, Princeton, NJ 08544-5002 | 2006-07-07 |
| 1750327342 | James P Morgan | Emergency Medicine | 277 Greasy Ridge Rd, Princeton, WV 24739-6900 | 2006-06-21 |
| 1306887674 | Gregg E Davis | Emergency Medicine | 204 Park Ave E, Princeton, IL 61356-2114 | 2006-06-09 |
| Find all providers in PRINCETON | ||||
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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.