Carol Mary Medins, MPH, RD, LDN, CNSC

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

L002778 Issued in NC

Practice address

Wakemed Raleigh Medical Park
23 Sunnybrook Road, Suite 200
Raleigh, NC 27610

Phone

(919) 235-6435

NPI assigned

Oct 31, 2018

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

• Carol Mary Jenkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375
  NPD (past)

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1639646367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SCOTTS RIDGE TRL",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275026584",
            "telephone_number": "919-302-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKEMED RALEIGH MEDICAL PARK",
            "address_2": "23 SUNNYBROOK ROAD, SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27610",
            "telephone_number": "919-235-6435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Healthplex Way",
            "address_purpose": "LOCATION",
            "city": "Apex",
            "state": "NC",
            "postal_code": "275028403",
            "country_code": "US",
            "telephone_number": "919-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINS",
        "first_name": "CAROL",
        "middle_name": "MARY",
        "credential": "MPH, RD, LDN, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NC",
            "license": "L002778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "JENKINS",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maribel Medina de la Barrera
• Celimar Medina Leon
• Bryiane Pascua Medina, FNP-BC
• Jennifer Kathryn Medina, L.C.S.W.
• Kaicie Medina
• Medique Medical Equipment Supply, Inc.
• Meditelecare of North Carolina PLLC
• Paul Ilolibi Medju, LCSW
• Tabu Keyunga Medju
• Cheryl Medley, MA. CCC-A

• Pediatric Nutrition Registered Dietitian in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatric Nutrition Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.