Active NPI
Shwu-Fang Lin, M.D.
- Pediatric Nephrology Physician
- Galveston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- 42612
- Practice address
- 301 University Blvd
Galveston, TX 77555-0373 - Phone
- (409) 772-0425
- Fax
- (409) 772-5293
- NPI assigned
- Sep 16, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD38699 | TN | |
| Pediatric Nephrology Physician | 2080P0210X | 42612 | TX | Primary |
Addresses
Primary practice location
301 University Blvd
Galveston, TX 77555-0373
Mailing address
301 University Blvd
Galveston, TX 77555-0373
Phone (409) 772-2538
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD38699 | TN | MD | Pediatrics Physician |
| 42612 | TX | MD | Pediatric Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Pediatrics | Current | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
2525 Cumberland Pkwy SE
Atlanta, GA 30339
Phone (770) 431-4145
750 Townpark Ln NW
Kennesaw, GA 30144
Phone (770) 514-5401
200 Crescent Center Pkwy
Tucker, GA 30084
Phone (770) 496-3609
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1194710087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 UNIVERSITY BLVD",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775550373",
"telephone_number": "409-772-2538",
"fax_number": "409-772-5293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 UNIVERSITY BLVD",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775550373",
"telephone_number": "409-772-0425",
"fax_number": "409-772-5293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "SHWU-FANG",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD38699",
"primary": false
},
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "TX",
"license": "42612",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "200 Crescent Center Pkwy",
"city": "Tucker",
"state": "GA",
"country_code": "US",
"postal_code": "300847047",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Galveston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.