Quynh Chau Bao Wang, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

124430 Issued in AR

Practice address

1024 Boulder Dr
Little Rock, AR 72210-4789

Phone

(936) 355-6035

NPI assigned

Jun 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Arkansas Heart Hospital Rural Health Services, LLC

  • Cardiovascular Disease Physician
  • Little Rock, AR
  • NPI 1548553811
  Medicare reassignment NPD
• Arkansas Heart Hospital, LLC

  • Cardiovascular Disease Physician
  • Little Rock, AR
  • NPI 1558653212
  Medicare reassignment NPD
• Arkansas Heart Hospital, LLC

  • General Acute Care Hospital
  • Bryant, AR
  • NPI 1841898293
  NPD
• Southwest Texas Two Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1659950475
  NPD (past)

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1205451853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 BOULDER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722104789",
            "telephone_number": "936-355-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 BOULDER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722104789",
            "telephone_number": "936-355-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "QUYNH",
        "middle_name": "CHAU BAO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "124430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob William Walz, MD
• Holli Wammack, QBHP
• Luke Elliot Wanamaker
• Chen Wang, M. D.
• Julia Marie Wang
• Yu-CHI Annie Wang, MD
• Yuxin Wang
• Muhammad Waqas, MD
• April Ward
• Bobby Ward, CSAC

• Gerontology Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Gerontology Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.