Individual provider Active NPI

Jing Jing Wong Harris, MD

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1285865113
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67745 Issued in GA
Practice address
1800 Howell Mill Rd NW
#130
Atlanta, GA 30318-2538
Phone
(404) 355-8775
Fax
(678) 601-6229
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.057069 IL
Family Medicine Physician 207Q00000X 67745 GA Primary

Addresses

Primary practice location

1800 Howell Mill Rd NW
#130
Atlanta, GA 30318-2538

Mailing address

1800 Howell Mill Rd NW
#130
Atlanta, GA 30318-2538
Phone (404) 355-8775

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

LicenseStateTypeSpecialty
67745GAMDFamily Medicine Physician
125.057069ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine and Urgent Care, P.C. Family Medicine CurrentSince Nov 1, 2012 Accepting new patients
Observation Medicine Specialists LLC Past Accepting new patients

Locations

4415 Front Nine Dr
Ste 700
Cumming, GA 30041
Phone (614) 905-2700

Organizations & group practices 2

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1285865113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW",
            "address_2": "#130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182538",
            "telephone_number": "404-355-8775",
            "fax_number": "678-601-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW",
            "address_2": "#130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182538",
            "telephone_number": "404-355-8775",
            "fax_number": "678-601-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JING JING",
        "middle_name": "WONG",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.057069",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "67745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.