Active NPI
Phuong Kim Tang Sr.
- Physical Therapy Assistant
- Wheaton, MD
National Provider Identifier
1710445903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A2120
- Practice address
- 11901 Georgia Ave
Wheaton, MD 20902-2001 - Phone
- (301) 942-2500
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A2120 | MD | Primary |
Addresses
Primary practice location
11901 Georgia Ave
Wheaton, MD 20902-2001
Mailing address
9915 E Light Dr
Silver Spring, MD 20903-1902
Other practice location 1
14200 Laurel Park Dr
Laurel, MD 20707-5201
Phone (410) 792-4717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A2120 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1710445903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9915 E LIGHT DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209031902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11901 GEORGIA AVE",
"city": "WHEATON",
"state": "MD",
"postal_code": "209022001",
"telephone_number": "301-942-2500"
}
],
"practiceLocations": [
{
"address_1": "14200 Laurel Park Dr",
"address_purpose": "LOCATION",
"city": "Laurel",
"state": "MD",
"postal_code": "207075201",
"country_code": "US",
"telephone_number": "410-792-4717",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANG",
"first_name": "PHUONG",
"middle_name": "KIM",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A2120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.