Jeffery Michael Medina, RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

RN-81127 Issued in NM

Practice address

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Phone

(505) 913-5503

NPI assigned

Feb 17, 2017

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1932648383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 HOWLING WOLF LN",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875070815",
            "telephone_number": "505-515-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-913-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JEFFERY",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NM",
            "license": "RN-81127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah G Meadows, LMSW
• Meaningful Change Learning Services, LLC
• Brandon Medina
• Danielle Medina
• Diana Medina, PA-C
• Juan Medina
• Julie Darlene Medina, TEACHER
• Leasa Medina, LCSW
• Brenda Berenice Medina, LPCC, LPCC
• Yvette M Medina

• Medical-Surgical Registered Nurse in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Medical-Surgical Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.