Active NPI
Jennifer H Wang, DPM
- Podiatrist
- Austin, TX
National Provider Identifier
1619950565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 1646
- Practice address
- 13502 Paddington Cir
Austin, TX 78729-1930 - Phone
- (877) 801-1188
- Fax
- (888) 592-3646
- NPI assigned
- Nov 23, 2005
- Last updated
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 1646 | TX | Primary |
| Foot Surgery Podiatrist | 213ES0131X | 1646 | TX | |
| Foot Surgery Podiatrist | 213ES0131X | N005645 | NY |
Addresses
Primary practice location
13502 Paddington Cir
Austin, TX 78729-1930
Mailing address
13502 Paddington Cir
Austin, TX 78729-1930
Phone (877) 801-1188
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160910903 | Medicaid | TX | |
| 160910901 | Medicaid | TX | |
| P00695818 | Other | TX | RAILROAD |
| 8CS732 | Other | TX | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005645 | NY | MD | Mental Health Counselor |
| N005645 | NY | MD | Foot Surgery Podiatrist |
| 1646 | TX | MD | Orthotist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ambulatory Foot Care | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Foot Surgery Podiatrist
- Austin, TX
- NPI 1194960997
-
- Primary Podiatric Medicine Podiatrist
- Lancaster, TX
- NPI 1427119262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1619950565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13502 PADDINGTON CIR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787291930",
"telephone_number": "877-801-1188",
"fax_number": "888-592-3646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13502 PADDINGTON CIR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787291930",
"telephone_number": "877-801-1188",
"fax_number": "888-592-3646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JENNIFER",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-23",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "TX",
"license": "1646",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "TX",
"license": "1646",
"primary": false
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "NY",
"license": "N005645",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "160910903",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "160910901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00695818",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "8CS732",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.