Individual provider Active NPI

Judy Xiong

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1669712089
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9501688 Issued in CA
Practice address
568 E Herndon Ave Ste 201
Fresno, CA 93720-2989
Phone
(559) 228-6600
Fax
(559) 226-3709
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95018688 CA
Primary Care Nurse Practitioner 363LP2300X 95018688 CA
Nurse Practitioner 363L00000X 9501688 CA Primary

Addresses

Primary practice location

568 E Herndon Ave Ste 201
Fresno, CA 93720-2989

Mailing address

568 E Herndon Ave Ste 201
Fresno, CA 93720-2989
Phone (559) 228-6600

Other identifiers 1

IdentifierTypeStateIssuer
10AQMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220117000291 CA Practitioner - Nurse Practitioner 0840682274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9501688CAMDNurse Practitioner
95018688CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nephrology Group, Inc. Clinical Lab CurrentSince Jul 1, 2022 Accepting new patients
The Nephrology Group, Inc. Current Accepting new patients

Locations

568 E Herndon Ave
Ste 201
Fresno, CA 93720
Phone (559) 228-9660

Interoperability endpoints

  • Direct secure messaging: judy.xiong.1@17661.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1669712089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 E HERNDON AVE STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202989",
            "telephone_number": "559-228-6600",
            "fax_number": "559-226-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 E HERNDON AVE STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202989",
            "telephone_number": "559-228-6600",
            "fax_number": "559-226-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "JUDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018688",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95018688",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "9501688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10AQ",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.