Individual provider Active NPI

Ying Jin, NP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1053959536
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0029477 Issued in OH
Practice address
5700 Karl Rd
Columbus, OH 43229-3602
Phone
(614) 846-5420
Fax
(614) 438-5873
NPI assigned
Dec 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0029477 OH Primary

Addresses

Primary practice location

5700 Karl Rd
Columbus, OH 43229-3602

Mailing address

355 Bryn Du Dr
Granville, OH 43023-1512
Phone (786) 493-3950

Other practice location 1

355 Bryn Du Dr
Granville, OH 43023-1512
Phone (786) 493-3950

Other identifiers 1

IdentifierTypeStateIssuer
145513MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20220127002840 OH Practitioner - Nurse Practitioner 2163814906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0029477OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince Aug 6, 2023 Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince May 4, 2025 Accepting new patients

Locations

335 Illinois St
Crystal Lake, IL 60014
Phone (815) 459-7791

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

4550 Hills and Dales Rd NW
Canton, OH 44708
Phone (234) 360-0789

441 Norton Rd
Columbus, OH 43228
Phone (614) 794-8800

5700 Karl Rd
Columbus, OH 43229
Phone (614) 846-5420

717 S 30th St
Newark, OH 43056
Phone (740) 522-1171

7120 Port Sylvania Dr
Toledo, OH 43617
Phone (419) 841-2200

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complexcare Medical Group Midwest H PLLC 128 clinicians

Practice addresses (Care Compare)

5700 Karl Rd
Columbus, OH 43229-3602
Phone (614) 846-5420

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1053959536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BRYN DU DR",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430231512",
            "telephone_number": "786-493-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 KARL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293602",
            "telephone_number": "614-846-5420",
            "fax_number": "614-438-5873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Bryn Du Dr",
            "address_purpose": "LOCATION",
            "city": "Granville",
            "state": "OH",
            "postal_code": "430231512",
            "country_code": "US",
            "telephone_number": "786-493-3950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIN",
        "first_name": "YING",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0029477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145513",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.