Individual provider Active NPI

Alice One Jang, CPNP

  • Pediatric Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1962722611
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R225379 Issued in MD
Practice address
11161 New Hampshire Ave
Suite 301
Silver Spring, MD 20904-2606
Phone
(301) 681-7101
Fax
(855) 885-1472
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R225379 MD
Pediatric Nurse Practitioner 363LP0200X R225379 MD Primary

Addresses

Primary practice location

11161 New Hampshire Ave
Suite 301
Silver Spring, MD 20904-2606

Mailing address

11161 New Hampshire Ave
Suite 301
Silver Spring, MD 20904-2606
Phone (301) 681-7101

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R225379MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1962722611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11161 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 301",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042606",
            "telephone_number": "301-681-7101",
            "fax_number": "855-885-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11161 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 301",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042606",
            "telephone_number": "301-681-7101",
            "fax_number": "855-885-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "ALICE",
        "middle_name": "ONE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R225379",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R225379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.