Active NPI
Lin Wong, CRNP
- Acute Care Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1174915722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- SP014732
- Practice address
- 3401 N Broad St
Parkinson Pavilion, Suite 400
Philadelphia, PA 19140-5103 - Phone
- (215) 707-3133
- NPI assigned
- Feb 19, 2015
- Sex
- Female
- 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 | SP014732 | PA | Primary |
Addresses
Primary practice location
3401 N Broad St
Parkinson Pavilion, Suite 400
Philadelphia, PA 19140-5103
Mailing address
3401 N Broad St
Rock Pavillion, 9TH Floor, Office: A9-F021
Philadelphia, PA 19140-5103
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 |
|---|---|---|---|
| SP014732 | PA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485129600000",
"number": "1174915722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"address_2": "ROCK PAVILLION, 9TH FLOOR, OFFICE: A9-F021",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"address_2": "PARKINSON PAVILION, SUITE 400",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "215-707-3133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "LIN",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-19",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "PA",
"license": "SP014732",
"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 Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.