1831120773 NPI number — DR. JUNPING YANG MD

Table of content: DR. JUNPING YANG MD (NPI 1831120773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831120773 NPI number — DR. JUNPING YANG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANG
Provider First Name:
JUNPING
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831120773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 HEARTLAND RD
Provider Second Line Business Mailing Address:
SUITE 4810
Provider Business Mailing Address City Name:
SAINT JOSEPH
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64506-6200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-271-1343
Provider Business Mailing Address Fax Number:
816-271-1321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 HEARTLAND RD
Provider Second Line Business Practice Location Address:
SUITE 4810
Provider Business Practice Location Address City Name:
SAINT JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64506-6200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-271-1343
Provider Business Practice Location Address Fax Number:
816-271-1321
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  108874 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 392551 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 10001498100 . This is a "CHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 209238203 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 27379011 . This is a "BCBS KC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 106092 . This is a "COVENTRY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 26D0975772 . This is a "CLIA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 2456405 . This is a "AETNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 460003044 . This is a "RR MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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