Individual provider Active NPI

Douachee Xiong

  • Licensed Practical Nurse
  • Fitchburg, WI
National Provider Identifier
1144686692
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
318752 Issued in WI
Practice address
2002 Shafer Dr
Fitchburg, WI 53711-4363
Phone
(608) 658-9171
NPI assigned
Jan 13, 2016
Last updated
Jan 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 318752 WI Primary

Addresses

Primary practice location

2002 Shafer Dr
Fitchburg, WI 53711-4363

Mailing address

2002 Shafer Dr
Fitchburg, WI 53711-4363
Phone (608) 658-9171

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
318752WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1144686692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 SHAFER DR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537114363",
            "telephone_number": "608-658-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 SHAFER DR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537114363",
            "telephone_number": "608-658-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "DOUACHEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "318752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.