Active NPI
Mary Vang
- Pharmacist
- Sheboygan, WI
National Provider Identifier
1235848334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21468-40
- Practice address
- 3711 S Taylor Dr
Sheboygan, WI 53081-8495 - Phone
- (920) 459-8601
- NPI assigned
- Nov 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Pharmacist | 1835C0205X | 21468-40 | WI | |
| Pharmacist | 183500000X | 21468-40 | WI | Primary |
Addresses
Primary practice location
3711 S Taylor Dr
Sheboygan, WI 53081-8495
Mailing address
1257 Kaufmann Ave
Sheboygan, WI 53081-7618
Phone (715) 302-2433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21468-40 | WI | MD | Critical Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1235848334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1257 KAUFMANN AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530817618",
"telephone_number": "715-302-2433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3711 S TAYLOR DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530818495",
"telephone_number": "920-459-8601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-17",
"last_updated": "2022-11-17",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "WI",
"license": "21468-40",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "21468-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.