Individual provider Active NPI

Xiong Vang

  • Pharmacist
  • Coon Rapids, MN
National Provider Identifier
1861123366
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
125428 Issued in MN
Practice address
3300 124TH Ave NW
Coon Rapids, MN 55433-3805
Phone
(763) 354-1626
NPI assigned
Jun 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 125428 MN Primary

Addresses

Primary practice location

3300 124TH Ave NW
Coon Rapids, MN 55433-3805

Mailing address

446 Ripley Ave
Maplewood, MN 55117-2481
Phone (651) 403-1795

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL other

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
125428MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1861123366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 RIPLEY AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551172481",
            "telephone_number": "651-403-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 124TH AVE NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333805",
            "telephone_number": "763-354-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "XIONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "address_1": "3300 124th Ave NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554333805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.