Individual provider Active NPI

Veronica Son Wang, MD

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1639632052
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0094560 Issued in MD
Practice address
8821 Columbia 100 Parkway
Columbia, MD 21045-2274
Phone
(410) 997-1700
Fax
(410) 730-6198
NPI assigned
Apr 11, 2019
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0094560 MD Primary

Addresses

Primary practice location

8821 Columbia 100 Parkway
Columbia, MD 21045-2274

Mailing address

8821 Columbia 100 Parkway
Columbia, MD 21045-2274
Phone (410) 997-1700

Other identifiers 1

IdentifierTypeStateIssuer
177409300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122002652 MD Practitioner - Pediatric Medicine 8123359353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Pediatrics Past 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, 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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1639632052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8821 COLUMBIA 100 PARKWAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452274",
            "telephone_number": "410-997-1700",
            "fax_number": "410-730-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8821 COLUMBIA 100 PARKWAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452274",
            "telephone_number": "410-997-1700",
            "fax_number": "410-730-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "VERONICA",
        "middle_name": "SON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0094560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177409300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.