Jie Kong, CRNP MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R143501 Issued in MD

Practice address

10802 Hickory Ridge Rd
Columbia, MD 21044-3622

Phone

(410) 997-1336

Fax

(410) 997-1636

NPI assigned

Aug 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Physician Services IncGroup PAC ID 4284631540, 144 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adventist Physician Services, Inc.

  dba Adventist Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Gaithersburg, MD
  • NPI 1376623207

  DC

  Medicare reassignment Care Compare group NPD
• Adventist Physician Services (Wah)

  • Cardiovascular Disease Physician
  • Rockville, MD
  • NPI 1144247024
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Pulmonary Disease and Critical Care Associates, P.a.

  dba Center for Sleep Disorders/Behavioral Sleep Medicine

  • Clinical Psychologist
  • Columbia, MD
  • NPI 1972838316
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1215040951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443622",
            "telephone_number": "410-997-1336",
            "fax_number": "410-997-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10802 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443622",
            "telephone_number": "410-997-1336",
            "fax_number": "410-997-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "JIE",
        "credential": "CRNP MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R143501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERHEALTH",
            "identifier": "5707",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038278500",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CAPITAL PPO",
            "identifier": "783571",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MARYLAND",
            "identifier": "90192801",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "293176",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1013404",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215040951",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS FEDERAL",
            "identifier": "N1510003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1013404",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411436100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therese Alexandra Kolb
• Omotanbaje Victoria Kole, DNP
• Ida Neneh Koli
• Robert Mark Kolodner, M.D.
• Adetutu Komolafe
• Angela M. Kopack, MD
• Cassandra Koplow
• Jan M Koppelman, M.D.
• James A Kopper, M.D
• Natasha Kormanik, MSN, FNP-BC, OCN

• Family Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.