MEDICARE: JESSICA JEMS OING NP-C

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN10031958	MA
2	363LF0000X	Family Nurse Practitioner	TMP-163115	KS
3	363LF0000X	Family Nurse Practitioner	A186329	IA
4	363LF0000X	Family Nurse Practitioner	APRN11033960	FL
5	363LF0000X	Family Nurse Practitioner	GAA-NP002438	GA
6	363LF0000X	Family Nurse Practitioner	023129	OH
7	363LF0000X	Family Nurse Practitioner	1206561	TX
8	363LF0000X	Family Nurse Practitioner	13928	MN
9	363LA2200X	Adult Health Nurse Practitioner	22208	SC
10	363LF0000X	Family Nurse Practitioner	5020409	NC
11	363LF0000X	Family Nurse Practitioner	2025034147	MO

NPI Number	:	1609347129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA JEMS OING NP-C

Provider Business Mailing Address
First Line	:	PO BOX 6069
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29171-6069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2728 SUNSET BLVD STE 300
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-4815
Country	:	US
Telephone Number	:	803-744-4940
Fax Number	:	803-744-4938

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2018
Last Update Date	:	02/26/2026

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308