Sanouk Xiong, DNP, NP-C FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5780 Issued in MN

Practice address

4112 Joyce LN
Brooklyn Center, MN 55429-4008

Phone

(763) 742-9757

NPI assigned

Feb 13, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1083114300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 JOYCE LN",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554294008",
            "telephone_number": "763-742-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 JOYCE LN",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554294008",
            "telephone_number": "763-742-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "SANOUK",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-C FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5780",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "5780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITONERS",
            "identifier": "F01180845",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wright Way Home Care LLC
• Linda B Wright, RN, NP
• Nyrie M'Cole Wright
• Steven Eric Wynia, PHYSICALTHERAPISTMPT
• Lalita Xiong
• Adriene Yang
• Andrew Yeeleng Yang
• Cynthia Yang
• Dominic Yang
• Kathy Yang, CMT

• Primary Care Nurse Practitioner in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Primary Care Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.