Jennifer Kathryn Medina, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007020 Issued in NC

Practice address

2108 Umstead Dr
Raleigh, NC 27603

Phone

(919) 445-0837

Fax

(919) 733-9441

NPI assigned

Oct 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Kathryn Stevens Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Duke University Health System, Inc.

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977

  Clinical

  Medicare reassignment NPD
• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment NPD
• Duke University Health System, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD
• Duke University Health System, Inc.

  • Social Worker
  • Durham, NC
  • NPI 1497912232
  NPD

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1346550522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NAVAHO DR",
            "address_2": "SUITE 114",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097319",
            "telephone_number": "919-297-2357",
            "fax_number": "919-890-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 UMSTEAD DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27603",
            "telephone_number": "919-445-0837",
            "fax_number": "919-733-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JENNIFER",
        "middle_name": "KATHRYN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "STEVENS",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Medical Nutrition and Integrative Medicine
• Medical Services of America, Inc.
• Maribel Medina de la Barrera
• Celimar Medina Leon
• Bryiane Pascua Medina, FNP-BC
• Kaicie Medina
• Carol Mary Medins, MPH, RD, LDN, CNSC
• Medique Medical Equipment Supply, Inc.
• Meditelecare of North Carolina PLLC
• Paul Ilolibi Medju, LCSW

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.