Individual provider Active NPI

Fang Wen

  • Anatomic Pathology & Clinical Pathology Physician
  • Columbia, MO
National Provider Identifier
1184945131
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2010017404 Issued in MO
Practice address
1 Hospital Dr
Gme, Dc018.00, Ma101
Columbia, MO 65201-5276
Phone
(573) 882-1201
Fax
(573) 884-4612
NPI assigned
Jun 14, 2010
Last updated
May 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA09771000 NJ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2010017404 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Gme, Dc018.00, Ma101
Columbia, MO 65201-5276

Mailing address

1 Hospital Dr
Gme, Dc018.00, Ma101
Columbia, MO 65201-5276
Phone (573) 882-1201

Other practice location 1

3311 Brunswick Pike
Lawrenceville, NJ 08648-2411
Phone (609) 716-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260512002869 NJ Practitioner - Pathology 4486123130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Floral Ave
New Providence, NJ 07974-1557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010017404MOMDAnatomic Pathology & Clinical Pathology Physician
25MA09771000NJMDAnatomic Pathology & Clinical Pathology Physician

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1184945131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "GME, DC018.00, MA101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-882-1201",
            "fax_number": "573-884-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "GME, DC018.00, MA101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-882-1201",
            "fax_number": "573-884-4612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Brunswick Pike",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "NJ",
            "postal_code": "086482411",
            "country_code": "US",
            "telephone_number": "609-716-7030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEN",
        "first_name": "FANG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA09771000",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2010017404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.