Individual provider Active NPI

Xala X Yang, APNP

  • Nurse Practitioner
  • Loganville, GA
National Provider Identifier
1962923292
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN309279 Issued in GA
Practice address
4398 Atlanta Hwy
Loganville, GA 30052-7314
Phone
(404) 948-3019
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7617 WI
Family Nurse Practitioner 363LF0000X 7617 WI
Nurse Practitioner 363L00000X RN309279 GA Primary

Addresses

Primary practice location

4398 Atlanta Hwy
Loganville, GA 30052-7314

Mailing address

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Other practice location 1

2500 E Capitol Dr
Appleton, WI 54911-8735
Phone (920) 830-5879

Other practice location 2

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 830-5879

Other identifiers 1

IdentifierTypeStateIssuer
100069124MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address xyang179134@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170804002461 WI Practitioner - Nurse Practitioner 2961773296 Reassigns benefits to 1 organization
I20220616000012 GA Practitioner - Nurse Practitioner 2961773296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

4398 Atlanta Hwy
Loganville, GA 30052-7314
Phone (678) 732-1519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7617WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jul 10, 2017 Accepting new patients
Piedmont Professional Services, LLC CurrentSince Jul 25, 2022 Accepting new patients
Thedacare, Incorporated CurrentSince Jul 10, 2017 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

4398 Atlanta Hwy
Loganville, GA 30052
Phone (678) 639-0213

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: xyang179134@direct.myadvocateaurora.org

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1962923292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047668",
            "telephone_number": "920-303-8700",
            "fax_number": "920-303-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4398 ATLANTA HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527314",
            "telephone_number": "404-948-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549118735",
            "country_code": "US",
            "telephone_number": "920-830-5879",
            "fax_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "54911",
            "country_code": "US",
            "telephone_number": "920-830-5879",
            "fax_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "XALA",
        "middle_name": "X",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7617",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7617",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN309279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100069124",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "xyang179134@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2500 E Capitol Dr",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549118735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2500 E Capitol Dr",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549118735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

Verify at the official NPI Registry.