Active NPI
Pazong Thao, APNP
- Family Nurse Practitioner
- Green Bay, WI
National Provider Identifier
1508740416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 17177-33
- Practice address
- 1920 Libal St
Green Bay, WI 54301-2453 - Phone
- (920) 432-5434
- NPI assigned
- Aug 4, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17177-33 | WI | Primary |
Addresses
Primary practice location
1920 Libal St
Green Bay, WI 54301-2453
Mailing address
1920 Libal St
Green Bay, WI 54301-2453
Phone (920) 432-5434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17177-33 | WI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787270400000",
"number": "1508740416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 LIBAL ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012453",
"telephone_number": "920-432-5434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 LIBAL ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012453",
"telephone_number": "920-432-5434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAO",
"first_name": "PAZONG",
"credential": "APNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-04",
"last_updated": "2026-08-21",
"certification_date": "2026-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "17177-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.