Individual provider Active NPI

Hannah Busung Kwon

  • Clinical Social Worker
  • Kirksville, MO
National Provider Identifier
1154138451
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2022046261 Issued in MO
Practice address
100 E Normal Ave
Kirksville, MO 63501-4200
Phone
(660) 785-4014
NPI assigned
Dec 11, 2024
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2022046261 MO Primary

Addresses

Primary practice location

100 E Normal Ave
Kirksville, MO 63501-4200

Mailing address

1611 S Baltimore St
Kirksville, MO 63501-4518
Phone (660) 785-4014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102002036 MO Practitioner - Clinical Social Worker 0941737977 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022046261MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Jan 13, 2025 Accepting new patients
Hannibal Regional Healthcare System, Inc Current Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Jan 13, 2025 Accepting new patients

Locations

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

100 E Normal Ave
Kirksville, MO 63501
Phone (660) 785-4014

1611 S Baltimore St
Kirksville, MO 63501
Phone (660) 372-9595

Interoperability endpoints

  • Direct secure messaging: hannah.kwon.p1@direct.cfmkv.nextgenshare.com
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

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, 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": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1154138451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014518",
            "telephone_number": "660-785-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NORMAL AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014200",
            "telephone_number": "660-785-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "HANNAH",
        "middle_name": "BUSUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022046261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.