Won S Jeon, CNM, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN161911 Issued in GA

Practice address

5673 Peachtree Dunwoody Rd Ste 870
Atlanta, GA 30342-5029

Phone

(404) 255-2975

Fax

(404) 255-2276

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Wanda Jeon Other name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1710919600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 PIEDMONT AVE NE UNIT 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303084311",
            "telephone_number": "770-312-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD STE 870",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425029",
            "telephone_number": "404-255-2975",
            "fax_number": "404-255-2276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "980 Johnson Ferry Rd NE Ste 620",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421608",
            "country_code": "US",
            "telephone_number": "404-255-2057",
            "fax_number": "404-256-4238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEON",
        "first_name": "WON",
        "middle_name": "S",
        "credential": "CNM, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN161911",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN161911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "JEON",
            "credential": "CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Noelle L Jennings, DO
• Sara Foppe Jennings, M.D.
• Stephanie Jennings, PT, DPT
• Sadie Jensen
• Tessa Jensen
• Jaewon Jeong, MD
• James Jeong, DMD, MD
• Lacey Jeong, MD
• Wook Jeong
• Katelyn Christine Jepson

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.