Jennifer Lea Medina, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2015001624 Issued in CO

Practice address

115 E Riverwalk
Unit 200
Pueblo, CO 81003-3308

Phone

(719) 543-8346

Fax

(970) 667-0847

NPI assigned

Nov 20, 2015

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rocky Mountain Vein Institute Professional LLCGroup PAC ID 8325181431, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.medina.p1@direct.americanvein.nextgenshare.com

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.

• Rocky Mountain Vein Institute Professional LLC

  • Vascular & Interventional Radiology Physician
  • Pueblo, CO
  • NPI 1457685398
  Medicare reassignment Care Compare group NPD
• Rocky Mountain Vein Institute, PLLC

  • Vascular & Interventional Radiology Physician
  • Colorado Springs, CO
  • NPI 1457942898
  NPD (past)

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1659745164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7702",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370702",
            "telephone_number": "970-663-2742",
            "fax_number": "970-667-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E RIVERWALK",
            "address_2": "UNIT 200",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033308",
            "telephone_number": "719-543-8346",
            "fax_number": "970-667-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JENNIFER",
        "middle_name": "LEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "2015001624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynne Medin, PT
• Katherine Medina-Sanchez
• Alexander Medina, CAS. BS.
• Floyd Medina
• Jazalina Maria Medina
• Kaylene Medina
• Mark Medina, RN
• Sharon Medina
• Tina Medina, LPC
• Amanda H Medrano

• Family Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.

Verify at the official NPI Registry.