Individual provider Active NPI

Shuyan Wang, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1275716714
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
01057545A Issued in IN
Practice address
8780 Purdue Rd
Suite 7
Indianapolis, IN 46268-6129
Phone
(317) 471-8701
Fax
(317) 471-8702
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Physician 202C00000X 01057545A IN
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 01057545A IN Primary

Addresses

Primary practice location

8780 Purdue Rd
Suite 7
Indianapolis, IN 46268-6129

Mailing address

8780 Purdue Rd
Suite 7
Indianapolis, IN 46268-6129
Phone (317) 471-8701

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
139516CAMDMarriage & Family Therapist
01057545AINMDIndependent Medical Examiner Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter North Medical Foundation PastSince Feb 1, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1275716714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8780 PURDUE RD",
            "address_2": "SUITE 7",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686129",
            "telephone_number": "317-471-8701",
            "fax_number": "317-471-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8780 PURDUE RD",
            "address_2": "SUITE 7",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686129",
            "telephone_number": "317-471-8701",
            "fax_number": "317-471-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHUYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "IN",
            "license": "01057545A",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01057545A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; 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.