Individual provider Active NPI

Philip Wang, CPNP-PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1730517608
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.15007 Issued in OH
Practice address
765 Pierce Dr
Columbus, OH 43223-2425
Phone
(614) 223-1650
NPI assigned
Oct 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN.CNP.15007 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.15007 OH Primary

Addresses

Primary practice location

765 Pierce Dr
Columbus, OH 43223-2425

Mailing address

765 Pierce Dr
Columbus, OH 43223-2425

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.15007OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Jan 6, 2025 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Jan 6, 2025 Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1730517608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 PIERCE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 PIERCE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232425",
            "telephone_number": "614-223-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "PHILIP",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-31",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.15007",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.15007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.