Individual provider Active NPI

Xiangyu Tan

  • Pharmacist
  • Warr Acres, OK
National Provider Identifier
1790151504
Registry record updated Aug 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16236 Issued in OK
Practice address
6350 N Macarthur Blvd
Warr Acres, OK 73122-7213
Phone
(405) 728-8396
NPI assigned
Aug 16, 2015
Last updated
Aug 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16236 OK Primary

Addresses

Primary practice location

6350 N Macarthur Blvd
Warr Acres, OK 73122-7213

Mailing address

6350 N Macarthur Blvd
Warr Acres, OK 73122-7213

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

LicenseStateTypeSpecialty
16236OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1439683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439683200000",
    "number": "1790151504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 N MACARTHUR BLVD",
            "city": "WARR ACRES",
            "state": "OK",
            "postal_code": "731227213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 N MACARTHUR BLVD",
            "city": "WARR ACRES",
            "state": "OK",
            "postal_code": "731227213",
            "telephone_number": "405-728-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "XIANGYU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-16",
        "last_updated": "2015-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "16236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warr Acres, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2015; 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.