Active NPI
Johanna De Jesus Mena Rosas, NP
- Nurse Practitioner
- Asheboro, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5018721
- Practice address
- 138 Dublin Square Rd Ste C
Asheboro, NC 27203-8601 - Phone
- (336) 625-3333
- Fax
- (336) 626-8233
- NPI assigned
- May 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5018721 | NC | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
138 Dublin Square Rd Ste C
Asheboro, NC 27203-8601
Mailing address
100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
138 Dublin Square Rd
Suite C
Asheboro, NC 27203-8601
Phone (336) 625-3333
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.3 of 100
- Promoting interoperability
- 98
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5018721 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest Health Network LLC | Current | Accepting new patients | |
| Wake Forest Health Network LLC | Current | Accepting new patients | |
| Wake Forest Health Network, LLC | Current | Accepting new patients | |
| Wake Forest Health Network LLC | Past | Accepting new patients | |
| Cornerstone Health Care LLC | Past | Accepting new patients |
Locations
223 W Ward St
#B
Asheboro, NC 27203
138 Dublin Square Rd
Ste C
Asheboro, NC 27203
Phone (336) 625-3333
905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040
100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947
Interoperability endpoints
- jmenarosas2753557@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 5
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.
-
- Pediatrics Physician
- Greensboro, NC
- NPI 1477785756
-
- Family Medicine Physician
- Asheboro, NC
- NPI 1225153984
-
- Pediatrics Physician
- Greensboro, NC
- NPI 1053175299
-
- Clinical Medical Laboratory
- Conover, NC
- NPI 1871159145
-
- Family Medicine Physician
- Granite Falls, NC
- NPI 1770858938
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1639817372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KIMEL FOREST DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036074",
"telephone_number": "336-716-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 DUBLIN SQUARE RD STE C",
"city": "ASHEBORO",
"state": "NC",
"postal_code": "272038601",
"telephone_number": "336-625-3333",
"fax_number": "336-626-8233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENA ROSAS",
"first_name": "JOHANNA",
"middle_name": "DE JESUS",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-23",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5018721",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Asheboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.