Active NPI
Jennifer Elizabeth Light Diep
- Family Medicine Physician
- Danville, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD457969
- Practice address
- 100 N Academy Ave
Danville, PA 17822-1339 - Phone
- (570) 271-6211
- NPI assigned
- Apr 8, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D97054 | MD | |
| Family Medicine Physician | 207Q00000X | MD457969 | PA | Primary |
Addresses
Primary practice location
100 N Academy Ave
Danville, PA 17822-1339
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Other practice location 1
600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-5000
Other names 1
- Jennifer Elizabeth Light
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD457969 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Los Angeles Medical Group, Inc. | Current | Accepting new patients | |
| Johns Hopkins University | Current | Accepting new patients | |
| Johns Hopkins University | Current | Accepting new patients | |
| Johns Hopkins University | Current | Accepting new patients | |
| The Johns Hopkins Hospital | Past | Accepting new patients |
Locations
3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550
4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122
600 N Wolfe St
Baltimore, MD 21287
601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080
6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704
Interoperability endpoints
- jdiep1125499@direct.hopkinsmedicine.org
Organizations & group practices 5
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.
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- Anesthesiology Physician
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- General Acute Care Hospital
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1356784573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178221339",
"telephone_number": "570-271-6211"
}
],
"practiceLocations": [
{
"address_1": "600 N Wolfe St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870005",
"country_code": "US",
"telephone_number": "410-955-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIEP",
"first_name": "JENNIFER",
"middle_name": "ELIZABETH LIGHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-08",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D97054",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD457969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "LIGHT",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.