Paul Ilolibi Medju, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011360 Issued in NC

Practice address

1526 Mark Massengill Dr
Raleigh, NC 27610-4454

Phone

(919) 633-3792

NPI assigned

Jan 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Blessing Care Services

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1629741715

  Clinical

  Medicare reassignment NPD Authorized official
• The Enhancement Center, Inc.

  • Community/Behavioral Health Agency
  • Clayton, NC
  • NPI 1396004602
  Medicare reassignment NPD
• Blessing Care Services, LLC

  • Home Health Agency
  • Raleigh, NC
  • NPI 1598518870
  NPD (past) Authorized official
• Blessing Care Services, LLC

  • In Home Supportive Care Agency
  • Raleigh, NC
  • NPI 1750035101
  NPD (past) Authorized official

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1407214919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 MARK MASSENGILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104454",
            "telephone_number": "919-633-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 MARK MASSENGILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104454",
            "telephone_number": "919-633-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDJU",
        "first_name": "PAUL",
        "middle_name": "ILOLIBI",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-29",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kathryn Medina, L.C.S.W.
• Kaicie Medina
• Carol Mary Medins, MPH, RD, LDN, CNSC
• Medique Medical Equipment Supply, Inc.
• Meditelecare of North Carolina PLLC
• Tabu Keyunga Medju
• Cheryl Medley, MA. CCC-A
• Cara Peterson Medlin, BSN, RN, CCRN
• Chasity Marie Medlin
• Keri Medlin, PHARM.D

• 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 Jul 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.