Jinxia Peng

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A159964 Issued in IA

Practice address

9823 Biscayne Dr
Johnston, IA 50131-3002

Phone

(203) 752-8950

NPI assigned

Sep 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1669088654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9823 BISCAYNE DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501313002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9823 BISCAYNE DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501313002",
            "telephone_number": "203-752-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "JINXIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A159964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ipad",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9823 Biscayne Dr",
            "city": "Johnston",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501313002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David James Parr
• Kyra Pastor, BCBA
• Pathways to Growth Psychotherapy LLC
• Jillane Elise Paul, R.PH.
• Allison Jean Peel, DC, DACBR
• Holly Perkins, LBSW
• Sarah Peshel, BCABA
• Sydney Peter
• Michael Peters, PHARM.D.
• Jay D Petersma, O.D.

• Family Nurse Practitioner in Johnston, IA
• Providers in Johnston, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.