Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sourasack Kit Vongsa, MD

Individual provider Family Medicine Physician · NPI 1619945524

Sourasack Kit Vongsa, MD is a Family Practice in Appleton, Wisconsin. Qualified in 2003, 23 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
23
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2500 E Capitol Dr Ste 1200
Appleton, WI 54911
Phone: (920) 830-6877
Fax: (800) 236-2236
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727
  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727
  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727
  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 47253 (WI)

Record details

NPI number1619945524
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 8, 2006
Last updated in NPPESAugust 19, 2019
Mailing address122 E College Ave, Appleton, WI 54911-5794

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Appleton