Active NPI
Jiah K. Waldon
- Social Worker
- Jacksonville, NC
National Provider Identifier
1871392829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- P021791
- Practice address
- 2457 Gum Branch Rd Unit 800
Jacksonville, NC 28540-4008 - Phone
- (910) 939-0836
- Fax
- (910) 634-1026
- NPI assigned
- Mar 12, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | P021791 | NC | Primary |
Addresses
Primary practice location
2457 Gum Branch Rd Unit 800
Jacksonville, NC 28540-4008
Mailing address
114 Shamrock Dr
Jacksonville, NC 28540-4061
Phone (720) 271-2836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P021791 | NC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741737600000",
"number": "1871392829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 SHAMROCK DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285404061",
"telephone_number": "720-271-2836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2457 GUM BRANCH RD UNIT 800",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285404008",
"telephone_number": "910-939-0836",
"fax_number": "910-634-1026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDON",
"first_name": "JIAH",
"middle_name": "K.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-12",
"last_updated": "2025-03-12",
"certification_date": "2025-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NC",
"license": "P021791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.