Active NPI
Jingwen Ni, PHD
- Clinical Psychologist
- Fort Worth, TX
National Provider Identifier
1689357741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 39608
- Practice address
- 2553 Birchcrest Dr
Fort Worth, TX 76179-2522 - Phone
- (817) 381-5023
- NPI assigned
- Aug 7, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 39608 | TX | Primary |
Addresses
Primary practice location
2553 Birchcrest Dr
Fort Worth, TX 76179-2522
Mailing address
2553 Birchcrest Dr
Fort Worth, TX 76179-2522
Phone (817) 381-5023
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39608 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1689357741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2553 BIRCHCREST DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761792522",
"telephone_number": "817-381-5023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2553 BIRCHCREST DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761792522",
"telephone_number": "817-381-5023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NI",
"first_name": "JINGWEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-07",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "39608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.