Active NPI
Peter S Vang, PA
- Surgical Physician Assistant
- Wichita, KS
National Provider Identifier
1063428811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- T-00858
- Practice address
- 9300 E 29TH St N
Suite 205
Wichita, KS 67226-2182 - Phone
- (316) 219-8299
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | APPLIED FOR TEMP | KS | |
| Surgical Physician Assistant | 363AS0400X | T-00858 | KS | Primary |
Addresses
Primary practice location
9300 E 29TH St N
Suite 205
Wichita, KS 67226-2182
Mailing address
9300 E 29TH St N
Suite 205
Wichita, KS 67226-2182
Phone (316) 219-8299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T-00858 | Other | KS | STATE LICENSE # |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APPLIED FOR TEMP | KS | MD | Surgical Physician Assistant |
| T-00858 | KS | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063428811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 E 29TH ST N",
"address_2": "SUITE 205",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262182",
"telephone_number": "316-219-8299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 E 29TH ST N",
"address_2": "SUITE 205",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262182",
"telephone_number": "316-219-8299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "PETER",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "KS",
"license": "APPLIED FOR TEMP",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "KS",
"license": "T-00858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "T-00858",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.