JIE KONG CRNP MSN NPI 1215040951

NPI Information

NPI: 1215040951
Provider Name: JIE KONG, CRNP MSN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
10802 HICKORY RIDGE RD
COLUMBIA, MD
ZIP 21044
Phone: (410) 997-1336
Get Directions

Jie Kong, CRNP MSN is a family nurse practitioner in Columbia, MD. Jie Kong, CRNP MSN NPI is 1215040951. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10802 HICKORY RIDGE RD
COLUMBIA, MD
ZIP 21044-622
Phone: (410) 997-1336
Fax: (410) 997-1636

The NPI 1215040951 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/16/2006 and was last updated on 1/26/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	R143501	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1013404	OTHER	MARYLAND	COVENTRY
2	1215040951	MEDICAID	MARYLAND
3	038278500	MEDICAID	DISTRICT OF COLUMBIA
4	157PP089	MEDICARE PIN	MARYLAND
5	293176	OTHER	MARYLAND	KAISER
6	783571	OTHER	MARYLAND	NATIONAL CAPITAL PPO
7	1013404	OTHER	VIRGINIA	FIRST HEALTH
8	N1510003	OTHER	MARYLAND	BLUE CROSS FEDERAL
9	5707	OTHER	MARYLAND	ELDERHEALTH
10	90192801	OTHER	MARYLAND	BLUE CROSS OF MARYLAND
11	Q74111	MEDICARE UPIN	MARYLAND
12	411436100	MEDICAID	MARYLAND
13	020357174	MEDICARE PIN	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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