Individual provider Active NPI

Deborah Kristina Wang, LPN

  • Licensed Practical Nurse
  • Mason, OH
National Provider Identifier
1952161176
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.186458 Issued in OH
Practice address
4483 US Route 42
Mason, OH 45040
Phone
(866) 934-7450
NPI assigned
Mar 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.186458 OH Primary

Addresses

Primary practice location

4483 US Route 42
Mason, OH 45040

Mailing address

4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600
Phone (513) 374-0153

Other names 1

  • Deborah Kristina Stanley Former name

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
LPN.186458OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1952161176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "513-374-0153",
            "fax_number": "866-934-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4483 US ROUTE 42",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "866-934-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "DEBORAH",
        "middle_name": "KRISTINA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.186458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "STANLEY",
            "middle_name": "KRISTINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.