Active NPI
Jessy Awiten Ang
- Psychiatry Physician
- Tacoma, WA
National Provider Identifier
1255544359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 18096
- Practice address
- 2411 S 19TH St
Tacoma, WA 98405-2954 - Phone
- (253) 627-6606
- Fax
- (253) 572-4291
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 18096 | WA | Primary |
Addresses
Primary practice location
2411 S 19TH St
Tacoma, WA 98405-2954
Mailing address
2411 S 19TH St
Tacoma, WA 98405-2954
Phone (253) 627-6606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548908 | Medicaid | WA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18096 | WA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Health System | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric Hospital Unit
- Tacoma, WA
- NPI 1497978100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255544359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 S 19TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052954",
"telephone_number": "253-627-6606",
"fax_number": "253-572-4291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2411 S 19TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052954",
"telephone_number": "253-627-6606",
"fax_number": "253-572-4291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANG",
"first_name": "JESSY",
"middle_name": "AWITEN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "18096",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1548908",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.