Individual provider Active NPI

Jenny Song, APRN

  • Family Nurse Practitioner
  • Ewing, NJ
National Provider Identifier
1124294558
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
003778 Issued in CT
Practice address
1001 Pennington Rd
Ewing, NJ 08618-2600
Phone
(609) 882-0777
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP010354 PA
Family Nurse Practitioner 363LF0000X 003778 CT Primary
Family Nurse Practitioner 363LF0000X 26NJ00261300 NJ

Addresses

Primary practice location

1001 Pennington Rd
Ewing, NJ 08618-2600

Mailing address

1001 Pennington Rd
Ewing, NJ 08618-2600
Phone (609) 882-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003778CTMDFamily Nurse Practitioner
SP010354PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louis G. Fares II, MD, Facs, LLC Past Accepting new patients
St Francis Medical Associates, PA Past Accepting new patients
Prohealth Physicians PC Family Past Accepting new patients
Lifecare Physicians, P.C Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3152/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1124294558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PENNINGTON RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086182600",
            "telephone_number": "609-882-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PENNINGTON RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086182600",
            "telephone_number": "609-882-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JENNY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010354",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003778",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00261300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.