Individual provider Active NPI

Lizhen Wang, MD

  • Pediatrics Physician
  • Norcross, GA
National Provider Identifier
1902862535
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101221157 Issued in VA
Practice address
510 Beaver Ruin Road
Suite B
Norcross, GA 30071
Phone
(770) 446-2820
Fax
(770) 446-2868
NPI assigned
Apr 22, 2006
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101221157 VA Primary

Addresses

Primary practice location

510 Beaver Ruin Road
Suite B
Norcross, GA 30071

Mailing address

10134 Colvin Run Rd
Suite D
Great Falls, VA 22066-1841
Phone (703) 757-7950

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 Medicine

State licenses

LicenseStateTypeSpecialty
0101221157VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Kennestone Pediatric Associates, LLC Pediatrics Past Accepting new patients
Virginia Allergy & Pediatric Associates, P.C. Past Accepting new patients
Wellstar Health System, Inc. Pediatrics Past Accepting new patients
Virginia Allergy PLLC PastSince May 19, 2024 Accepting new patients

Organizations & group practices 4

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1902862535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10134 COLVIN RUN RD",
            "address_2": "SUITE D",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220661841",
            "telephone_number": "703-757-7950",
            "fax_number": "703-757-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BEAVER RUIN ROAD",
            "address_2": "SUITE B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30071",
            "telephone_number": "770-446-2820",
            "fax_number": "770-446-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LIZHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101221157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.