Active NPI
Destiny Vang
- Other Technician
- Rochester, MN
National Provider Identifier
1255000642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 1470 Industrial Dr NW
Rochester, MN 55901-0700 - Phone
- (507) 322-7751
- NPI assigned
- Sep 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | MN | Primary |
Addresses
Primary practice location
1470 Industrial Dr NW
Rochester, MN 55901-0700
Mailing address
351 Labore Rd Apt 216
Little Canada, MN 55117-1120
Phone (763) 670-8030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00045697800 | Other | MN | UCARE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631145600000",
"number": "1255000642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 LABORE RD APT 216",
"city": "LITTLE CANADA",
"state": "MN",
"postal_code": "551171120",
"telephone_number": "763-670-8030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1470 INDUSTRIAL DR NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559010700",
"telephone_number": "507-322-7751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "DESTINY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-09",
"last_updated": "2021-09-09",
"certification_date": "2021-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "00045697800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.