Individual provider Active NPI

Hee Won Jeong, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1730555814
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP025261 Issued in PA
Practice address
125 S 9TH St
Philadelphia, PA 19107-5125
Phone
(215) 592-4500
NPI assigned
Aug 12, 2015
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 SP014617 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP025261 PA Primary
Critical Care Medicine Registered Nurse 163WC0200X RN604883 PA

Addresses

Primary practice location

125 S 9TH St
Philadelphia, PA 19107-5125

Mailing address

1030 East Lancaster Avenue
#1019
Bryn Mawr, PA 19010-1446
Phone (267) 272-2363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160114001315 PA Practitioner - Nurse Practitioner 6305149915 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN604883PAMDCritical Care Medicine Registered Nurse
SP014617PAMDFamily Nurse Practitioner
SP025261PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Management Corporation CurrentSince Jun 1, 2022 Accepting new patients
Public Health Management Corporation Current Accepting new patients

Locations

1200 Callowhill St
Ste 101
Philadelphia, PA 19123
Phone (215) 825-8212

125 S 9th St
Philadelphia, PA 19107
Phone (215) 592-4500

216 W Somerset St
Philadelphia, PA 19133
Phone (215) 763-8870

501 S 54th St
Ste 255
Philadelphia, PA 19143
Phone (215) 748-9200

5675 N Front St
Philadelphia, PA 19120
Phone (215) 224-0440

Interoperability endpoints

  • Direct secure messaging: jeong.heewon.p2@direct.alegiscare.nextgenshare.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, 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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1730555814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 EAST LANCASTER AVENUE",
            "address_2": "#1019",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101446",
            "telephone_number": "267-272-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075125",
            "telephone_number": "215-592-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "HEE WON",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014617",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025261",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN604883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.