Active NPI
Jheesoo Ahn
- Acute Care Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1174486989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- SP034127
- Practice address
- 3400 Civic Center Blvd
Philadelphia, PA 19104-5127 - Phone
- (215) 662-2000
- NPI assigned
- Dec 8, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | SP034127 | PA | Primary |
Addresses
Primary practice location
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Mailing address
4519 Chestnut St Unit 537
Philadelphia, PA 19139-3969
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP034127 | PA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1174486989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4519 CHESTNUT ST UNIT 537",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191393969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "215-662-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHN",
"first_name": "JHEESOO",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-12-08",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "PA",
"license": "SP034127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.