Individual provider Active NPI

Jenna Tong, CNM

  • Advanced Practice Midwife
  • Suwanee, GA
National Provider Identifier
1013656354
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN298050 Issued in GA
Practice address
2685 Peachtree Pkwy Ste 300
Suwanee, GA 30024-1048
Phone
(770) 771-5270
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X CNM07804 GA
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X RN298050 GA Primary

Addresses

Primary practice location

2685 Peachtree Pkwy Ste 300
Suwanee, GA 30024-1048

Mailing address

1914 Variations Dr NE
Atlanta, GA 30329-1009
Phone (310) 387-2135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250617000661 CA Practitioner - Certified Nurse Midwife (CNM) 6103337175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4560 Admiralty Way
Suite 105
Marina del Rey, CA 90292-5424
Phone (310) 694-5255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
CNM07804GAMDAdvanced Practice Midwife
RN298050GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jamie a. Lipeles, a Professional Medical Corporation Single Specialty CurrentSince Mar 28, 2025 Accepting new patients

Locations

301 W Carson St
Carson, CA 90745
Phone (310) 694-5255

11602 Hawthorne Blvd
Ste C
Hawthorne, CA 90250

11602 Hawthorne Blvd
Ste A
Hawthorne, CA 90250
Phone (310) 263-1400

2401 E 1st St
Los Angeles, CA 90033
Phone (310) 694-5255

4560 Admiralty Way
Ste 105
Marina del Rey, CA 90292
Phone (310) 629-2447

4500 Tweedy Blvd
South Gate, CA 90280
Phone (310) 694-5255

2320 Redondo Beach Blvd
Torrance, CA 90504
Phone (310) 323-6646

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jenna.tong.1@14654.direct.athenahealth.com

Organizations & group practices 1

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1013656354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 VARIATIONS DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303291009",
            "telephone_number": "310-387-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 PEACHTREE PKWY STE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241048",
            "telephone_number": "770-771-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONG",
        "first_name": "JENNA",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "CNM07804",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN298050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.