Vivian Medina

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1014 Whitehead Road Ext
Ewing, NJ 08638-2406

Phone

(609) 771-3777

NPI assigned

Dec 21, 2022

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1912619909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 WHITEHEAD ROAD EXT",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086382406",
            "telephone_number": "609-771-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WHITEHEAD ROAD EXT",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086382406",
            "telephone_number": "609-771-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Suzanne McGuire, PT, DPT
• Kellie A McIntyre, MA, LPC
• Meals on Wheels of Mercer County, Inc.
• Medallion Care Hamilton
• Medexpress Urgent Care - New Jersey, Inc
• Meditelecare of New Jersey LLC
• Medop Behavioral Health Associates of New Jersey PC
• Zaid Meer, OBAT NAVIGATOR
• Jennings Ubadi Mekoba
• Mary Mena

• Counselor in Ewing, NJ
• Providers in Ewing, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.
• 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.