Individual provider Active NPI

Yaqiong Wang, PT, DPT

  • Physical Therapist
  • Overland Park, KS
National Provider Identifier
1447878780
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2020024848 Issued in MO
Practice address
11120 Antioch Rd Ste 17
Overland Park, KS 66210-2420
Phone
(913) 451-7373
Fax
(913) 451-7375
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-06522 KS
Physical Therapist 225100000X 2020024848 MO Primary

Addresses

Primary practice location

11120 Antioch Rd Ste 17
Overland Park, KS 66210-2420

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200730003700 KS Practitioner - Physical Therapist in Private Practice 1951726462 Reassigns benefits to 1 organization
I20200813003698 MO Practitioner - Physical Therapist in Private Practice 1951726462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

10074 Woodland Dr
Serc Lenexa
Lenexa, KS 66220-3802
Phone (913) 764-0389

11120 Antioch Rd
Suite 17
Overland Park, KS 66210-2420
Phone (913) 451-7373

12755 S Mur Len Rd
B1 Serc Olathe
Olathe, KS 66062-6804
Phone (913) 782-8729

13035 Kansas Ave
Serc Bonner Springs
Bonner Springs, KS 66012-9206
Phone (913) 721-6362

8019 W 151St St
Overland Park, KS 66223-2115
Phone (913) 685-5835

827 NE Lakewood Blvd
Serc Lakewood Blvd
Lees Summit, MO 64064-1366
Phone (816) 533-6931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-06522KSMDPhysical Therapist
2020024848MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Serc Rebabilitation Partners, LLC Physical Therapist CurrentSince Aug 10, 2020 Accepting new patients
Serc Rehabilitation Partners, LLC Physical Therapist CurrentSince Aug 10, 2020 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

13035 Kansas Ave
Bonner Springs, KS 66012
Phone (913) 721-6362

11120 Antioch Rd
Ste 17
Overland Park, KS 66210
Phone (913) 451-7372

1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051

109 W Franklin St
Clinton, MO 64735
Phone (660) 383-1280

827 NE Lakewood Blvd
Lees Summit, MO 64064
Phone (816) 533-6931

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 2

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1447878780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 ANTIOCH RD STE 17",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102420",
            "telephone_number": "913-451-7373",
            "fax_number": "913-451-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "YAQIONG",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06522",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020024848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.