Individual provider Active NPI

Phoua Y Yang, PHARMD

  • Pharmacist
  • Wausau, WI
National Provider Identifier
1770367476
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20102-40 Issued in WI
Practice address
630 S 3Rd Ave
Wausau, WI 54401-5352
Phone
(715) 567-5700
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20102-40 WI Primary

Addresses

Primary practice location

630 S 3Rd Ave
Wausau, WI 54401-5352

Mailing address

630 S 3Rd Ave
Wausau, WI 54401-5352
Phone (715) 567-5700

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20102-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wausau Family Pharmacy LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

630 S 3rd Ave
Wausau, WI 54401
Phone (715) 567-5700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1770367476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 3RD AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015352",
            "telephone_number": "715-567-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S 3RD AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015352",
            "telephone_number": "715-567-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "PHOUA",
        "middle_name": "Y",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "20102-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.