Jenna Kanoelani Wong

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11847623-1204 Issued in UT

Practice address

475 W 940 N
Provo, UT 84604-3301

Phone

(801) 357-7940

NPI assigned

Mar 17, 2019

Last updated

Aug 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fauquier Physician Practices LLCGroup PAC ID 6406083104, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
• Fauquier Hospital Hospital, Warrenton, VA, CCN 490023
• Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
• Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenna.wong.1@16767.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fauquier Physician Practices LLC

  • Internal Medicine Physician
  • Warrenton, VA
  • NPI 1770916983

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba McKay Dee Neurology

  • Neurology Physician
  • Ogden, UT
  • NPI 1215172093
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

• Fauquier Medical Center LLC

  dba Fauquier Health

  • General Acute Care Hospital
  • Warrenton, VA
  • NPI 1912334517
  Care Compare affiliation
• Inova Health Care Services

  dba Inova Fairfax Hospital

  • Rehabilitation Hospital Unit
  • Falls Church, VA
  • NPI 1588795462
  Care Compare affiliation
• Inova Health Care Services

  dba Inova Fairfax Hospital

  • General Acute Care Hospital
  • Falls Church, VA
  • NPI 1831220714
  Care Compare affiliation
• Uva Prince William Medical Center

  dba UVA Health Haymarket Medical Center

  • General Acute Care Hospital
  • Haymarket, VA
  • NPI 1124369137
  Care Compare affiliation
• Uva Prince William Medical Center

  dba UVA Health Prince William Medical Center

  • General Acute Care Hospital
  • Manassas, VA
  • NPI 1417005760
  Care Compare affiliation

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

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1417416785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301",
            "telephone_number": "801-357-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JENNA",
        "middle_name": "KANOELANI",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-17",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11847623-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubretia Danielle Wojahn
• Alexandra Wolf, OTD, OTR/L
• Louie T Wolfgramm, RPH
• Owen E Wolfgramm, D.D.S.
• Brian L Wolsey, M.D.
• Brian Wood, PHARMD
• Brooke Wood, APRN
• Casey Wood
• Christopher R Wood, M.D.
• Cindy W Wood, RN

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.