Individual provider Active NPI

Jennifer Fu Jiang, MD

  • Family Medicine Physician
  • Winter Park, FL
National Provider Identifier
1508410697
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TRN29838 Issued in FL
Practice address
133 Benmore Dr Ste 201
Winter Park, FL 32792-4111
Phone
(407) 646-7757
NPI assigned
Jul 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN29838 FL Primary

Addresses

Primary practice location

133 Benmore Dr Ste 201
Winter Park, FL 32792-4111

Mailing address

133 Benmore Dr Ste 201
Winter Park, FL 32792-4111
Phone (407) 646-7757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190828003538 FL Order and Referring Only - Family PracticePractitioner - Family Practice 4486982428

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1508410697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "JENNIFER",
        "middle_name": "FU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-28",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN29838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.