Individual provider Active NPI

Jinni Wang

  • Student in an Organized Health Care Education/Training Program
  • Fayetteville, AR
National Provider Identifier
1902740558
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3 E Appleby Rd Ste 302
Fayetteville, AR 72703-3160
Phone
(479) 404-1400
Fax
(479) 404-1401
NPI assigned
Apr 15, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3 E Appleby Rd Ste 302
Fayetteville, AR 72703-3160

Mailing address

3 E Appleby Rd Ste 302
Fayetteville, AR 72703-3160
Phone (479) 404-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20260626001502 AR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5294208674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1902740558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E APPLEBY RD STE 302",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033160",
            "telephone_number": "479-404-1400",
            "fax_number": "479-404-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E APPLEBY RD STE 302",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033160",
            "telephone_number": "479-404-1400",
            "fax_number": "479-404-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JINNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.