Jan Q Wu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301056301 Issued in MI

Practice address

1600 W Grand River Ave
Suite 4
Okemos, MI 48864-2394

Phone

(517) 381-6880

Fax

(517) 381-6881

NPI assigned

Sep 13, 2006

Last updated

Dec 31, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1831294016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-6253",
            "fax_number": "517-364-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W GRAND RIVER AVE",
            "address_2": "SUITE 4",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642394",
            "telephone_number": "517-381-6880",
            "fax_number": "517-381-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "JAN",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301056301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3229836",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP PIN #",
            "identifier": "200000001062",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "0803302102",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodward Detroit CVS LLC (CVS Pharmacy #16143)
• Andrew Worden
• Cassandra Wormack, MD
• Wound RX Medical Michigan PLLC
• Wray of Light, PLLC (Aligned Connections)
• Wychers-Caldwell Counseling PLLC
• Linda Wychers-Caldwell, LMSW
• Kranthi L Yanala, RPH
• Diane Lynn Yancer, RN
• Yancy a. Tygesen, D.D.S., M.S.,P.C.

• Family Medicine Physician in Okemos, MI
• Providers in Okemos, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.