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1043672090 NPI number — JAMIE JIAO MD

NPI Number: 1043672090
Health Care Provider/Practitioner: JAMIE JIAO MD

Information about “1043672090” NPI (JAMIE JIAO MD) exists in 1043672090 in HTML format HTML  |  1043672090 in plain Text format TXT  |  1043672090 in PDF (Portable Document Format) PDF  |  1043672090 in an XML format XML  formats.

NPI Number : 1043672090 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1043672090",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JIAO",
    "FirstName": "JAMIE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "201 DEFENSE HWY STE 205",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANNAPOLIS",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21401-7096",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "855-527-7246",
    "MailingAddressFaxNumber": "866-229-5063",
    "FirstLinePracticeLocationAddress": "8505 ARLINGTON BLVD STE 420",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRFAX",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22031-4636",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "855-527-7246",
    "PracticeLocationAddressFaxNumber": "866-229-5063",
    "EnumerationDate": "03/28/2016",
    "LastUpdateDate": "06/26/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2081P2900X",
          "TaxonomyName": "Pain Medicine (Physical Medicine & Rehabilitation) Physician",
          "LicenseNumber": "0101284910",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "208100000X",
          "TaxonomyName": "Physical Medicine & Rehabilitation Physician",
          "LicenseNumber": "21161",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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