Active NPI
Xiong Vang
- Pharmacist
- Coon Rapids, MN
National Provider Identifier
1861123366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 125428
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 125428 | MN | MD | Pharmacist |
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.