Jon Gabriel Medina, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10899873-4405 Issued in UT

Practice address

1310 24TH Ave S
Nashville, TN 37212-2637

Phone

(615) 873-7450

NPI assigned

Jul 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1649756354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "615-873-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "615-873-7450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Lebanon Rd",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371291392",
            "country_code": "US",
            "telephone_number": "615-225-3720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JON",
        "middle_name": "GABRIEL",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP138067",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "33381",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "10899873-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicos Nashville Family Medicine, LLC
• Medimove Solutions LLC
• Brenda B Medina, M.D.
• Chelsea R Medina, MA
• Emily Siren Medina, MOT, OTR/L
• Leaitrice Sterling Medina, B.S.
• Omar Medina, M.D.
• Meditech Solutions LLC
• Meditranz, LLC
• Meditrina Consulting LLC

• Psychiatric/Mental Health Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.