Individual provider Active NPI

Jovanka Medina, MSW,LSW

  • Social Worker
  • Canon City, CO
National Provider Identifier
1437026879
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0009926216 Issued in CO
Practice address
600 Evans Rd
Canon City, CO 81212
Phone
(719) 267-5757
NPI assigned
Oct 21, 2025
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 0009926216 CO Primary

Addresses

Primary practice location

600 Evans Rd
Canon City, CO 81212

Mailing address

PO Box 999
Canon City, CO 81215-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0009926216COMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1437026879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 999",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812150999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EVANS RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "81212",
            "telephone_number": "719-267-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JOVANKA",
        "credential": "MSW,LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "0009926216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.