Individual provider Active NPI

Julia Margaret Kwon, DO

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1003133463
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4783 Issued in OK
Practice address
1705 E 19TH St Ste 302
Tulsa, OK 74104-5410
Phone
(918) 748-7585
Fax
(918) 748-7539
NPI assigned
Apr 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4783 OK Primary

Addresses

Primary practice location

1705 E 19TH St Ste 302
Tulsa, OK 74104-5410

Mailing address

1705 E 19TH St Ste 302
Tulsa, OK 74104-5410
Phone (918) 748-7585

Other identifiers 1

IdentifierTypeStateIssuer
200292190AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Internal Medicine CurrentSince Oct 10, 2011 Accepting new patients
Omni Medical Group Inc Internal Medicine CurrentSince Feb 6, 2012 Accepting new patients
St. John Physicians, Inc CurrentSince Oct 10, 2011 Accepting new patients

Locations

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1003133463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045410",
            "telephone_number": "918-748-7585",
            "fax_number": "918-748-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045410",
            "telephone_number": "918-748-7585",
            "fax_number": "918-748-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JULIA",
        "middle_name": "MARGARET",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "4783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200292190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.