Individual provider Active NPI

PO Lung Lang, FNP-C

  • Nurse Practitioner
  • Sheridan, WY
National Provider Identifier
1598352312
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95016187 Issued in CA
Practice address
1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777
Phone
(307) 302-0318
NPI assigned
Dec 28, 2020
Last updated
Jul 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95016187 CA Primary

Addresses

Primary practice location

1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777

Mailing address

6861 Alamo Way
La Mesa, CA 91942-5860
Phone (718) 791-5126

Other names 1

  • Ms. PO Lung Ngai Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210212002165 CA Practitioner - Nurse Practitioner 8426463084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95016187CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose and Throat Associates of San Diego a Medical Corp CurrentSince Feb 1, 2021 Accepting new patients
Emergency and Acute Care Medical Corporation PastSince Feb 1, 2021 Accepting new patients

Locations

5565 Grossmont Center Dr
Ste 101
La Mesa, CA 91942
Phone (619) 464-3353

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1598352312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6861 ALAMO WAY",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919425860",
            "telephone_number": "718-791-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE STE 1200",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777",
            "telephone_number": "307-302-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "PO",
        "middle_name": "LUNG",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PO",
            "last_name": "NGAI",
            "middle_name": "LUNG",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.