NPIMap

Individual provider Active NPI

Nan Jiang

  • Neurology Physician
  • Leland, NC
National Provider Identifier
1407388630
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2022-01989 Issued in NC
Practice address
1333 S Dickinson Dr Unit 230
Leland, NC 28451-6434
Phone
(910) 662-7500
Fax
(910) 662-7501
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 2022-01989 NC Primary

Addresses

Primary practice location

1333 S Dickinson Dr Unit 230
Leland, NC 28451-6434

Mailing address

PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 662-7500

Other practice location 1

1430 Tulane Ave # Sl50
New Orleans, LA 70112-2632
Phone (504) 988-7809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220808001260 NC Practitioner - Neurology 4587046537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wright State University Boonshoft School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1333 S Dickinson Dr
Unit 230
Leland, NC 28451-6434
Phone (910) 662-8550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022-01989NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC Neurology CurrentSince Jul 8, 2022 Accepting new patients
NMG Health Services LLC CurrentSince Jul 8, 2022 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

1333 S Dickinson Dr
Unit 230
Leland, NC 28451
Phone (910) 254-1033

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

Interoperability endpoints

  • Direct secure messaging: njiang1426897@direct.novanthealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1407388630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-662-7500",
            "fax_number": "910-662-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S DICKINSON DR UNIT 230",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516434",
            "telephone_number": "910-662-7500",
            "fax_number": "910-662-7501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave # Sl50",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-7809",
            "fax_number": "504-988-3971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "NAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2022-01989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.