Individual provider Active NPI

Florence Jingwa Mbekem Tanjong

  • Psychiatric/Mental Health Nurse Practitioner
  • Reynoldsburg, OH
National Provider Identifier
1790110443
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024028452 Issued in OH
Practice address
1609 Dream CT
Reynoldsburg, OH 43068-1576
Phone
(614) 209-0250
NPI assigned
Sep 12, 2013
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024028452 OH Primary
Licensed Practical Nurse 164W00000X NP-117004-MEDS OH

Addresses

Primary practice location

1609 Dream CT
Reynoldsburg, OH 43068-1576

Mailing address

1609 Dream CT
Reynoldsburg, OH 43068-1576
Phone (614) 209-0250

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

State licenses

LicenseStateTypeSpecialty
NP-117004-MEDSOHMDLicensed Practical Nurse
2024028452OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Jingwa Mbekemtanjong Past Accepting new patients

Organizations & group practices 1

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": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1790110443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 DREAM CT",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681576",
            "telephone_number": "614-209-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 DREAM CT",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681576",
            "telephone_number": "614-209-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBEKEM TANJONG",
        "first_name": "FLORENCE",
        "middle_name": "JINGWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "2024028452",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "NP-117004-MEDS",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.