Kevin Kongmeng Yang

Primary specialty

PharmacistTaxonomy code 183500000X

License

21244-40 Issued in WI

Practice address

1010 N 8TH St
Medford, WI 54451-1278

Phone

(715) 748-9020

Fax

(715) 748-9022

NPI assigned

Mar 7, 2022

Last updated

Mar 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-3643

  • Community/Retail Pharmacy
  • Medford, WI
  • NPI 1285810614
  NPD (past)

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1215684584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 WINDING RIDGE WAY APT 39",
            "city": "SCHOFIELD",
            "state": "WI",
            "postal_code": "544766801",
            "telephone_number": "715-212-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 8TH ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511278",
            "telephone_number": "715-748-9020",
            "fax_number": "715-748-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "KEVIN",
        "middle_name": "KONGMENG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21244-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wildberg Chiropractic Office SC (Wildberg Chiropractic)
• Bradley Dale Wildberg, DC
• Korby J Wipf, MA CCC-SLP
• Anne Marie Wolf, PTA
• Jiho Yang, DMD
• Margaret Susan Young, MD
• Craig Zalizniak, DC
• Debra Jeanne Zenner, N.P.
• Shane Arthur Zertler
• Donna Jane Zielke, LPN

• Pharmacist in Medford, WI
• Providers in Medford, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.