Fangyuan Jin-Dominguez

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

0101287821 Issued in VA

Practice address

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Phone

(804) 675-5000

NPI assigned

Apr 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Fangyuan Jin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1295232296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-675-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-675-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN-DOMINGUEZ",
        "first_name": "FANGYUAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.144467",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101287821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FANGYUAN",
            "last_name": "JIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yajing Ji, DO
• Rafael M. Jimenez Riveros, MD
• Keriann Jimenez
• Jennifer Runk Jimerson, RPH
• Jimmy Vo, LLC (Cavalier Physical Therapy & Wellness)
• Eva Jin, MD
• Lucy Jin
• Paul M Jiral, D.D.S.
• Jjwllc
• Jlcmd PLLC

• Gastroenterology Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Gastroenterology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.