Individual provider Active NPI

Jacquelyn Maria Steen, MSN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1568000982
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5012725 Issued in NC
Practice address
4551 New Bern Ave
Ste 160
Raleigh, NC 27610
Phone
(919) 556-1008
NPI assigned
Dec 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 201914081 NC
Pediatric Nurse Practitioner 363LP0200X 5012725 NC Primary

Addresses

Primary practice location

4551 New Bern Ave
Ste 160
Raleigh, NC 27610

Mailing address

103 Kilbreck Dr
Cary, NC 27511-6340
Phone (919) 434-9535

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsteen@wakemed.org

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
I20200417000092 NC Practitioner - Nurse Practitioner 3577993419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201914081NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Nov 8, 2021 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Nov 8, 2021 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1568000982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 KILBRECK DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116340",
            "telephone_number": "919-434-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 NEW BERN AVE",
            "address_2": "STE 160",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27610",
            "telephone_number": "919-556-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEEN",
        "first_name": "JACQUELYN",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "MSN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "201914081",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5012725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsteen@wakemed.org",
            "affiliation": "N",
            "address_1": "4551 New Bern Ave",
            "address_2": "Ste 160",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.