Jan Winsome West, MSN, PMHCNS/NP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5004710 Issued in NC

Practice address

1805 Tilley Farm Rd
Rougemont, NC 27572-9309

Phone

(919) 451-6645

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science - Nursing, Nurse Practitioner

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.

• Whiteville Mat Services, Inc.

  • Methadone Clinic
  • Whiteville, NC
  • NPI 1740868744
  NPD
• Recovery Innovations, Inc

  • Community/Behavioral Health Agency
  • Greenville, NC
  • NPI 1609009919
  NPD (past)
• Therapeutic Alternatives Incorporated

  • Clinical Social Worker
  • Asheboro, NC
  • NPI 1386662831
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1487876975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 TILLEY FARM RD",
            "city": "ROUGEMONT",
            "state": "NC",
            "postal_code": "275729309",
            "telephone_number": "919-451-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 TILLEY FARM RD",
            "city": "ROUGEMONT",
            "state": "NC",
            "postal_code": "275729309",
            "telephone_number": "919-451-6645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3622 Lyckan Pkwy Ste 3008A",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277072566",
            "country_code": "US",
            "telephone_number": "919-451-6645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "JAN",
        "middle_name": "WINSOME",
        "credential": "MSN, PMHCNS/NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "105380",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "138",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "105380",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5004710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6113093",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Stepanski-Roberts, MSPT
• Courtney Taylor
• Sarah M Taylor, LCSW
• Carlson Andrews Theodore, LCMHC
• Joia Ubia
• John Ying Lui Wong

• All providers in Rougemont, NC
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.