Active NPI
Yiwellness
- Family Medicine Physician
- Columbus, OH
National Provider Identifier
1184435109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- YIWELLNESS
- Doing business as
- Yi Wellness
- Practice address
- 1194 Old Henderson Rd Ste a
Columbus, OH 43220-3694 - Phone
- (614) 869-0085
- Fax
- (614) 869-0083
- NPI assigned
- Jan 17, 2025
- Last updated
- Jan 17, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stacey Guan, MD
- Title
- Ceo
- Phone
- (917) 754-0980
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary | |
| Neurology Physician | 2084N0400X | NU |
Addresses
Primary practice location
1194 Old Henderson Rd Ste a
Columbus, OH 43220-3694
Mailing address
1194 Old Henderson Rd Ste a
Columbus, OH 43220-3694
Phone (614) 869-0085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932429776 | Medicaid | OH |
Other names 1
- Yi Wellness
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1194 Old Henderson Rd
Ste A
Columbus, OH 43220
Phone (614) 451-8797
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Columbus, OH
- NPI 1932429776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737072000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737072000000",
"number": "1184435109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1194 OLD HENDERSON RD STE A",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432203694",
"telephone_number": "614-869-0085",
"fax_number": "614-869-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1194 OLD HENDERSON RD STE A",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432203694",
"telephone_number": "614-869-0085",
"fax_number": "614-869-0083"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YIWELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-17",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A",
"authorized_official_last_name": "GUAN",
"authorized_official_first_name": "STACEY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "917-754-0980",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932429776",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Yi Wellness",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.