NPIMap

Individual provider Active NPI

Jianxia Wang

  • Family Medicine Physician
  • Crestwood, KY
National Provider Identifier
1457693954
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48857 Issued in KY
Practice address
6411 Veterans Memorial Pkwy
Crestwood, KY 40014-8698
Phone
(502) 241-8611
Fax
(502) 241-4175
NPI assigned
Mar 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 103281 GA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 48857 KY Primary

Addresses

Primary practice location

6411 Veterans Memorial Pkwy
Crestwood, KY 40014-8698

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 272-5063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160831002975 KY Practitioner - Family Practice 8628296175 Reassigns benefits to 1 organization
I20250716001990 GA Practitioner - Family Practice 8628296175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48857KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Community Medical Associates, Inc. Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

12000 Findley Rd
Johns Creek, GA 30097

6411 Veterans Memorial Pkwy
Ste 100
Crestwood, KY 40014
Phone (502) 241-8611

6411 Veterans Memorial Pkwy
Crestwood, KY 40014
Phone (502) 241-8611

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: jwang1168806@direct.emory.org
  • Direct secure messaging: jwang59042@direct.nortonhealthcare.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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1457693954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-272-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 VETERANS MEMORIAL PKWY",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400148698",
            "telephone_number": "502-241-8611",
            "fax_number": "502-241-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JIANXIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "103281",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "48857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, KY

Sources for this page

Verify at the official NPI Registry.