Katherine Elizabeth Wong, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP017222 Issued in PA

Practice address

2085 N 63Rd St
Philadelphia, PA 19151-2675

Phone

(215) 452-0304

NPI assigned

Jun 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

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.

• Philadelphia Health Associates-Pediatrics, PC

  • Pediatrics Physician
  • Bala Cynwyd, PA
  • NPI 1770547499
  NPD (past)
• Plastic & Cosmetic Surgery Institute PC

  • Specialist
  • Vineland, NJ
  • NPI 1154639052
  NPD (past)

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1104355098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 GERMANTOWN AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19122",
            "telephone_number": "917-620-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 N 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512675",
            "telephone_number": "215-452-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00730000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033698760001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicia Pauline Wong
• Jacob Lee Wong
• Janet M Wong, MSN
• Jessica Karen Wong, M.D
• Justin Lee Wong
• Kelly Wong, MSN, FNP-BC
• Kristine Wong, DO
• Lim W Wong, MD
• Lin Wong, CRNP
• Mabel Wong

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.