Siushan Tang Vuong, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

102 Clark PL Apt S
Memphis, TN 38104-2419

Phone

(515) 867-0223

NPI assigned

Sep 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Physician Assistant

State licenses

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.

• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1134734817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CLARK PL APT S",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042419",
            "telephone_number": "515-867-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CLARK PL APT S",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042419",
            "telephone_number": "515-867-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUONG",
        "first_name": "SIUSHAN",
        "middle_name": "TANG",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9399",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Rae Vracar, DMD
• VRF Eye Specialty Group, PLC
• Andrew T Vu, MD
• Duy Toan H Vu, MD
• Nha Uyen Vu
• Neha Arvind Vyas, R.PH
• W.W. Taylor, Jr, M.D., P.C.
• Dawn Medley Waddell, PHARMD
• Patience Jarrett Waddell, DNP
• Tempia Waddell, LPC-MHSP

• Physician Assistant in Memphis, TN
• Providers in Memphis, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.