Active NPI
Jesper Jiang, MD
- Pediatrics Physician
- Charleston, SC
National Provider Identifier
1396585832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MMD92201LL
- Practice address
- 169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425 - Phone
- (843) 792-8972
- NPI assigned
- May 31, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MMD92201LL | SC | Primary |
Addresses
Primary practice location
169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425
Mailing address
169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425
Phone (843) 792-8972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241021004430 | SC | Order and Referring Only - Pediatric Medicine | 9537691035 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MMD92201LL | SC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1396585832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVENUE",
"address_2": "ROOM 202 MAIN HOSPITAL MSC333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-8972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVENUE",
"address_2": "ROOM 202 MAIN HOSPITAL MSC333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-8972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIANG",
"first_name": "JESPER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "MMD92201LL",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.