Jennifer Crystal Kleean

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5011919 Issued in NC

Practice address

1351 Westgate Center Dr
Winston Salem, NC 27103-2934

Phone

(336) 718-7777

Fax

(336) 718-7744

NPI assigned

Jun 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Crystal Rosdhal Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrosdhal11336@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Forsyth Pediatrics

  • Pediatrics Physician
  • Winston Salem, NC
  • NPI 1861163321
  NPD
• Novant Health Medical Group, LLC

  dba NHMG Primary Care Clinics

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1619538568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 WESTGATE CENTER DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032934",
            "telephone_number": "336-718-7777",
            "fax_number": "336-718-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEEAN",
        "first_name": "JENNIFER",
        "middle_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrosdhal11336@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1351 Westgate Center Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271032934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROSDHAL",
            "middle_name": "CRYSTAL",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teresa Ann Kivett
• Betty Kizito, PHARMD
• Madison Valente Klang, PA-C
• Gunnar Klauss
• Mary Garland Kledzik, MD
• Alan D Klein, M.D.
• Ilan Binyamin Klein, MD
• Patricia Mills Klein, P.A.-C
• Steven Russell Klein, M.D.
• Teressa Klein, MA

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.