Physician Compare National (NPI:1588702062)

HEALTHCARE PROVIDER: DAVID REYNOLDS MENDENHALL M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1588702062
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860598844
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070508000512
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MENDENHALL
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF UTAH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1968
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	501 S RANCHO DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 41
	Group Practice or individual's line 2 address
City	LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	891064834
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	290039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MOUNTAINVIEW HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y