Individual provider Active NPI

Jennifer H Wang, DPM

  • Podiatrist
  • Austin, TX
National Provider Identifier
1619950565
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1646 Issued in TX
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, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
160910903MedicaidTX
160910901MedicaidTX
P00695818OtherTXRAILROAD
8CS732OtherTXBC/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

LicenseStateTypeSpecialty
005645NYMDMental Health Counselor
N005645NYMDFoot Surgery Podiatrist
1646TXMDOrthotist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.