Brenda Medina

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1000174 Issued in TX

Practice address

14804 S Spring Ridge Cir
Balch Springs, TX 75180-4315

Phone

(214) 624-2092

NPI assigned

Jun 8, 2018

Sex

Female

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brenda.medina.1@30520.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nuevo Leon Family Clinic PLLC

  • Family Nurse Practitioner
  • Mesquite, TX
  • NPI 1972335347
  Medicare reassignment NPD Authorized official
• Salma Mazhar M.D. P.a.

  • Internal Medicine Physician
  • Mesquite, TX
  • NPI 1578796694
  Medicare reassignment
• Topcare Medical PA

  dba Clinicas Mi Doctor

  • Specialist
  • Irving, TX
  • NPI 1043231400
  NPD (past)

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1962995597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14804 S SPRING RIDGE CIR",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751804315",
            "telephone_number": "214-624-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14804 S SPRING RIDGE CIR",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751804315",
            "telephone_number": "214-624-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "BRENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1000174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake June Pharmacy LLC (Lake June Pharmacy)
• Johnny Lewis, PSY.D
• Jessica M Loera
• Dorothy Chestine Marshall, M.D, M.P.H
• Martin Luther King, Jr. Family Clinic (Foremost Family Health Centers)
• Michael D. Fulton, D.O., P.a.
• Michael L Ashley C. Ped
• Carolyn Ann Morrow
• Mossprime Dental PLLC
• National Vision, Inc. (America's Best Contacts & Eyeglasses)

• Family Nurse Practitioner in Balch Springs, TX
• Providers in Balch Springs, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.