Individual provider Active NPI

An Ngoc Dang DO, MD PHD

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1053571257
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
11014302A Issued in IN
Practice address
702 Barnhill Dr
Room 5867
Indianapolis, IN 46202-5128
Phone
(317) 278-0003
Fax
(317) 274-1476
NPI assigned
Jun 11, 2008
Last updated
Jun 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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 11014302A IN Primary

Addresses

Primary practice location

702 Barnhill Dr
Room 5867
Indianapolis, IN 46202-5128

Mailing address

702 Barnhill Dr
Room 5867
Indianapolis, IN 46202-5128
Phone (317) 278-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20121015000177 MD Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8426208117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11014302AINMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1053571257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BARNHILL DR",
            "address_2": "ROOM 5867",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025128",
            "telephone_number": "317-278-0003",
            "fax_number": "317-274-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BARNHILL DR",
            "address_2": "ROOM 5867",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025128",
            "telephone_number": "317-278-0003",
            "fax_number": "317-274-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "AN",
        "middle_name": "NGOC DANG",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11014302A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.