Zhan Wang

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6607076-4405 Issued in UT

Practice address

3702 S State St Ste 107
South Salt Lake, UT 84115-5096

Phone

(801) 288-2634

Fax

(801) 288-1186

NPI assigned

Sep 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates of Utah LLCGroup PAC ID 2769468065, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• UT PPO
• UT PPO D-SNP

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14360/brand/23/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/14360/brand/20/csg/1/fhir/r4

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.

• Nephrology Associates of Utah LLC

  • Nephrology Physician
  • Salt Lake City, UT
  • NPI 1750473948
  Medicare reassignment Care Compare group NPD
• Insight Family Practice LLC

  • Family Nurse Practitioner
  • Sandy, UT
  • NPI 1053954727
  Medicare reassignment NPD
• Ming-Wei Wu, Inc

  dba Professional Wound Specialists

  • Surgery Physician
  • Las Vegas, NV
  • NPI 1699975144

  UT

  Medicare reassignment NPD
• Kidney & Hypertension Institute of Northern Utah LLC

  • Nephrology Physician
  • Layton, UT
  • NPI 1366713471
  NPD (past)
• Kidney & Hypertension Institute of Utah PLLC

  • Nephrology Physician
  • Layton, UT
  • NPI 1508073545
  NPD (past)
• Liberty Dialysis-Woods Cross LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Woods Cross, UT
  • NPI 1396924957
  NPD (past)

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1205486420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "ZHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6607076-4405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "6607076-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205486420",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zwang31446@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "3702 S State St Ste 107",
            "city": "South Salt Lake",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841155096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vital Life Brands (Simply Wellness)
• Amy M. Wadsworth, MS
• Samuel Elias Wagner
• Anafernanda Walker, CSWI
• Kevynne Walker
• Shaun Elizabeth Ward, MSW, CSW
• Wasatch Artificial Kidney Center LLC (Fresenius Kidney Care Wasatch)
• Wasatch G O D Medical LLC
• Jessica Wassink, EDS
• Lisa D Watson, COTA/L

• Nurse Practitioner in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.