Individual provider Active NPI

Kwang S Han, MPT

  • Physical Therapist
  • Vienna, VA
National Provider Identifier
1194892331
Registry record updated Nov 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305203449 Issued in VA
Practice address
8320 Old Courthouse Rd
Suite 401
Vienna, VA 22182-3831
Phone
(703) 810-5214
Fax
(703) 810-5409
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X DC871116 DC
Physical Therapist 225100000X 2305203449 VA Primary

Addresses

Primary practice location

8320 Old Courthouse Rd
Suite 401
Vienna, VA 22182-3831

Mailing address

8320 Old Courthouse Rd
Suite 401
Vienna, VA 22182-3831
Phone (703) 810-5214

Other identifiers 2

IdentifierTypeStateIssuer
184961OtherVAANTHEM BCBS
716792OtherVANCPPO

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

State licenses

LicenseStateTypeSpecialty
DC871116DCMDPhysical Therapist
2305203449VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414886400000",
    "number": "1194892331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD",
            "address_2": "SUITE 401",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823831",
            "telephone_number": "703-810-5214",
            "fax_number": "703-810-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD",
            "address_2": "SUITE 401",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823831",
            "telephone_number": "703-810-5214",
            "fax_number": "703-810-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "KWANG",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "DC871116",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305203449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "184961",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "716792",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2014; 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.