Individual provider Active NPI

Regina Jing

  • Psychiatric/Mental Health Nurse Practitioner
  • Allen, TX
National Provider Identifier
1669019006
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP142497 Issued in TX
Practice address
828 Water Oak Dr
Allen, TX 75002-6370
Phone
(214) 682-1219
NPI assigned
Dec 4, 2019
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP142497 TX Primary

Addresses

Primary practice location

828 Water Oak Dr
Allen, TX 75002-6370

Mailing address

828 Water Oak Dr
Allen, TX 75002-6370
Phone (214) 682-1219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515000874 TX Practitioner - Nurse Practitioner 1658532643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3320 S Loop
Suite 256
Palestine, TX 75801-6984
Phone (903) 723-6136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Cherokee Community Enrichment Services CurrentSince Apr 1, 2020 Accepting new patients
Anderson Cherokee Community Enrichment Services Psychiatric/Mental Health Current Accepting new patients

Locations

1011 College Ave
Jacksonville, TX 75766
Phone (903) 541-2577

3320 S Loop 256
Palestine, TX 75801
Phone (903) 723-6136

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
B&D Our Homecare Dba Our Homecare IncDallas, TX, CCN 459315 Home health agency W-2 Managing Employee Jul 17, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1669019006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 WATER OAK DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750026370",
            "telephone_number": "214-682-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 WATER OAK DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750026370",
            "telephone_number": "214-682-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JING",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP142497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.