Active NPI
Jooneui Kwon, PA
- Physician Assistant
- East Meadow, NY
National Provider Identifier
1154612505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 014637
- Practice address
- 2201 Heampstead Tpke
East Meadow, NY 11554 - Phone
- (516) 572-6131
- Fax
- (516) 572-6153
- NPI assigned
- Apr 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 014637 | NY | Primary |
Addresses
Primary practice location
2201 Heampstead Tpke
East Meadow, NY 11554
Mailing address
2201 Heampstead Turnpike
Box 42
East Meadow, NY 11554
Phone (516) 572-6131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014637 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1154612505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 HEAMPSTEAD TURNPIKE",
"address_2": "BOX 42",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "11554",
"telephone_number": "516-572-6131",
"fax_number": "516-572-6153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 HEAMPSTEAD TPKE",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "11554",
"telephone_number": "516-572-6131",
"fax_number": "516-572-6153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "JOONEUI",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-20",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "014637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Meadow, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.