Yuxuan Wang, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P20455 Issued in NC

Practice address

7800 SW Durham Rd Ste 500
Tigard, OR 97224-7578

Phone

(323) 847-7987

NPI assigned

Jul 14, 2021

Last updated

Jul 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jerry Wang Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Dimond Physical Therapy and Performance Lab, LLC

  dba The KOR

  • Physical Therapist
  • Beaverton, OR
  • NPI 1184864365
  NPD

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1578135075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 SW DURHAM RD STE 500",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247578",
            "telephone_number": "323-847-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SW DURHAM RD STE 500",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247578",
            "telephone_number": "323-847-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "YUXUAN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "WANG",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walmart Inc. (WalMart Pharmacy 10-5935)
• Alicia Kimberly Walsh I
• Christine Walsh
• Thomas Daniel Walsh
• W. Todd Walton, P.T.
• Jennifer F Wanty
• Warby Parker Inc.
• Alison Ward-Haddan
• Chelsea Ward, LPC
• Stephanie Ward

• Physical Therapist in Tigard, OR
• Providers in Tigard, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.