Individual provider Active NPI

Jeff Wang Jin

  • Student in an Organized Health Care Education/Training Program
  • Nashville, TN
National Provider Identifier
1881344687
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1301 Medical Center Dr
Nashville, TN 37232-0028
Phone
(615) 322-5000
NPI assigned
Mar 25, 2022
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R3922 NH
Psychiatry Physician 2084P0800X 33463 NH
Student in an Organized Health Care Education/Training Program 390200000X Primary
Psychiatry Physician 2084P0800X 77487 TN

Addresses

Primary practice location

1301 Medical Center Dr
Nashville, TN 37232-0028

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (605) 322-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://ersdsofficial.iyo:8291/Gateway/DocumentSub Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126004243 NH Practitioner - Psychiatry 8527449065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of New HampshireGroup PAC ID 3870530579, 77 clinicians

Practice addresses (Care Compare)

36 Clinton St
Concord, NH 03301-2359
Phone (603) 271-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33463NHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monadnock Family Services CurrentSince Jul 10, 2025 Accepting new patients
State of New Hampshire CurrentSince Oct 1, 2024 Accepting new patients
State of New Hampshire CurrentSince Oct 1, 2024 Accepting new patients

Locations

36 Clinton St
Concord, NH 03301
Phone (603) 271-5075

40 Avon St
Keene, NH 03431
Phone (603) 352-1024

64 Main St
Ste 301
Keene, NH 03431
Phone (603) 357-6878

Organizations & group practices 3

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1881344687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "605-322-5000",
            "fax_number": "615-322-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MEDICAL CENTER DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320028",
            "telephone_number": "615-322-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "JEFF",
        "middle_name": "WANG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "R3922",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "33463",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "77487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://ersdsofficial.iyo:8291/Gateway/DocumentSub",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDr",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.