NPIMap

Individual provider Active NPI

Kim Ann Vo Dang, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • La Mesa, CA
National Provider Identifier
1760872188
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
A159626 Issued in CA
Practice address
8851 Center Dr Ste 500
La Mesa, CA 91942-3033
Phone
(619) 740-5757
NPI assigned
Jan 24, 2015
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 008202 GA
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X A159626 CA Primary

Addresses

Primary practice location

8851 Center Dr Ste 500
La Mesa, CA 91942-3033

Mailing address

8851 Center Dr Ste 500
La Mesa, CA 91942-3033
Phone (619) 740-5757

Other practice location 1

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Other practice location 2

120 N Lee St Ste A
Forsyth, GA 31029-2122
Phone (478) 994-0437

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200120000857 CA Practitioner - Family Practice 6709120645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharpcare Medical Group ApcGroup PAC ID 0244518736, 23 clinicians

Practice addresses (Care Compare)

8851 Ctr Dr
Suite 500
La Mesa, CA 91942-3033
Phone (619) 740-5757

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A159626CAMDHospice and Palliative Medicine (Family Medicine) Physician
008202GAMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharpcare Medical Group, Apc CurrentSince Nov 23, 2019 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients
Sharp Healthcare Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Central Georgia Family Medicine, LLC PastSince Oct 1, 2018 Accepting new patients

Locations

8851 Center Dr
Ste 500
La Mesa, CA 91942
Phone (619) 461-2660

230 Prospect Pl
Ste 340B
San Diego, CA 92118
Phone (619) 522-4000

Interoperability endpoints

  • Direct secure messaging: kdang20732@sharphealthcare.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1422057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1760872188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR STE 500",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423033",
            "telephone_number": "619-740-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR STE 500",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423033",
            "telephone_number": "619-740-5757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312012102",
            "country_code": "US",
            "telephone_number": "478-633-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 N Lee St Ste A",
            "address_purpose": "LOCATION",
            "city": "Forsyth",
            "state": "GA",
            "postal_code": "310292122",
            "country_code": "US",
            "telephone_number": "478-994-0437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "KIM ANN",
        "middle_name": "VO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-24",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "008202",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A159626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.