Individual provider Active NPI

Eugene Suk Kwon, PA-C

  • Physician Assistant
  • Rocky Mount, NC
National Provider Identifier
1154199628
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
901 N Winstead Ave
Rocky Mount, NC 27804-8467
Phone
(252) 937-0231
Fax
(252) 937-3113
NPI assigned
Dec 14, 2023
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

901 N Winstead Ave
Rocky Mount, NC 27804-8467

Mailing address

901 N Winstead Ave
Rocky Mount, NC 27804-8467
Phone (252) 937-0231

Other practice location 1

530 New Waverly Pl Ste 314
Cary, NC 27518-7414
Phone (919) 642-4802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703000841 NC Practitioner - Physician Assistant 5698219426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boice-Willis Clinic PAGroup PAC ID 0143122382, 58 clinicians

Practice addresses (Care Compare)

901 N Winstead Ave
Rocky Mount, NC 27804-8712
Phone (252) 937-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boice-Willis Clinic PA CurrentSince Nov 6, 2025 Accepting new patients
Boice-Willis Clinic, PA CurrentSince Nov 6, 2025 Accepting new patients

Locations

901 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0200

921 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0300

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1154199628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-937-0231",
            "fax_number": "252-937-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-937-0231",
            "fax_number": "252-937-3113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 New Waverly Pl Ste 314",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275187414",
            "country_code": "US",
            "telephone_number": "919-642-4802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "EUGENE",
        "middle_name": "SUK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-14",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.