Individual provider Active NPI

Thanh T Yang, O.D.

  • Optometrist
  • Burke, VA
National Provider Identifier
1275615890
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001579 Issued in VA
Practice address
5204A Rolling Rd
Burke, VA 22015-1605
Phone
(703) 425-2000
NPI assigned
Oct 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001579 VA Primary

Addresses

Primary practice location

5204A Rolling Rd
Burke, VA 22015-1605

Mailing address

9334 Burke Rd
Burke, VA 22015-3373
Phone (703) 978-1682

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001579VAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275615890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9334 BURKE RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153373",
            "telephone_number": "703-978-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204A ROLLING RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151605",
            "telephone_number": "703-425-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "THANH",
        "middle_name": "T",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.