Organization Active NPI

Yiwellness

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1184435109
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Authorized official

Name
Stacey Guan, MDNPI 1932429776
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1932429776MedicaidOH

Other names 1

  • Yi Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250922001068 OH Part B Supplier - Clinic/Group Practice 9931603958 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.