Individual provider Active NPI

Jennifer Esther Gonzalez, ARNP

  • Family Nurse Practitioner
  • Clayton, NC
National Provider Identifier
1043931926
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5019278 Issued in NC
Practice address
12701 US 70W Business
Clayton, NC 27520-2195
Phone
(919) 235-1968
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5019278 NC Primary

Addresses

Primary practice location

12701 US 70W Business
Clayton, NC 27520-2195

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0351

Other identifiers 1

IdentifierTypeStateIssuer
1043931926MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430000592 NC Practitioner - Nurse Practitioner 4688014244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

12701 US 70 Business Hwy W
Clayton, NC 27520-2195
Phone (919) 350-0554

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5019278NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians LLC CurrentSince Apr 21, 2024 Accepting new patients
Wake Specialty Physicians, LLC Current Accepting new patients
Wake Specialty Physicians LLC CurrentSince Apr 21, 2024 Accepting new patients
Wake Specialty Physicians LLC PastSince Nov 8, 2025 Accepting new patients

Locations

2216 E NC Highway 54
Durham, NC 27713
Phone (919) 544-2020

7021 NC Highway 751
Durham, NC 27707
Phone (919) 235-0365

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

6800 Glenwood Ave
Raleigh, NC 27612
Phone (919) 235-1939

4530 Fayetteville Rd
Raleigh, NC 27603
Phone (919) 235-1930

938 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 235-1525

2001 S Main St
Wake Forest, NC 27587
Phone (919) 562-3155

1260 N Arendell Ave
Zebulon, NC 27597
Phone (919) 235-1326

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1043931926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 US 70W BUSINESS",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202195",
            "telephone_number": "919-235-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNIFER",
        "middle_name": "ESTHER",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043931926",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.