Individual provider Active NPI

Jennifer Hieu Luong

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1003378639
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD477653 Issued in PA
Practice address
376 W 10TH Ave # 774
Columbus, OH 43210-1280
Phone
(614) 293-3570
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD477653 PA Primary

Addresses

Primary practice location

376 W 10TH Ave # 774
Columbus, OH 43210-1280

Mailing address

376 W 10TH Ave # 774
Columbus, OH 43210-1280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220823003248 PA Practitioner - Emergency Medicine 3274876933 Reassigns benefits to 1 organization
I20240104001133 TX Practitioner - Emergency Medicine 3274876933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD477653PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thoreau Clinic CurrentSince Nov 27, 2023 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 19, 2022 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 19, 2022 Accepting new patients
Pueblo Pintado Clinic Current Accepting new patients

Locations

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1003378639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 W 10TH AVE # 774",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 W 10TH AVE # 774",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-293-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "JENNIFER",
        "middle_name": "HIEU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD477653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.