Jenny Montgomery Miedema, RN, MSN, CPNP, NNPBC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

5005122 Issued in NC

Practice address

5524 Hospital N
Box 100500 Medical Center
Durham, NC 27710-0001

Phone

(919) 970-5721

Fax

(919) 681-6065

NPI assigned

Jan 17, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmontgomery647306@direct.unc.nchie.net

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.

• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment NPD
• Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1619150141
  NPD (past)

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1649541095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 ERWIN RD",
            "address_2": "SUITE 504, NEONATOLOGY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053824",
            "telephone_number": "919-970-5721",
            "fax_number": "919-681-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 HOSPITAL N",
            "address_2": "BOX 100500 MEDICAL CENTER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-970-5721",
            "fax_number": "919-681-6065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "984-974-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIEDEMA",
        "first_name": "JENNY",
        "middle_name": "MONTGOMERY",
        "credential": "RN, MSN, CPNP, NNPBC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2022-06-23",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NC",
            "license": "5005122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmontgomery647306@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittany Middleton
• Byron Keith Middleton, BA
• Jessica Middleton, MA, LPC
• John Middleton
• Yasmeen Adia Midgette, DO
• Andrea Miesmer, LCSWA
• Lauren Simpson Miglarese, PA
• Sheryl Mika, ICCE
• Mohamad Abdul Ghani Mikati, MD
• Asiyah Zahra Mikell

• Critical Care Neonatal Nurse Practitioner in Durham, NC
• Providers in Durham, NC by specialty
• Critical Care Neonatal Nurse Practitioner in North Carolina

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