Bin Kong

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC02006 Issued in TX

Practice address

3509 Durango Root CT
Fort Worth, TX 76244-1157

Phone

(682) 560-8066

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelly Kong May Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1265019517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 DURANGO ROOT CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762441157",
            "telephone_number": "682-560-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 DURANGO ROOT CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762441157",
            "telephone_number": "682-560-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "BIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC02006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREEN CARD",
            "identifier": "066-297-327",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MAY",
            "middle_name": "KONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daphne Kolstoe, M.S
• Amber Nicole Komorian
• Scharles Alicia Konadu, M.D.
• Sherry R Kondziela, MD
• Kong Global, LLC (DFW Alliance Care Pharmacy)
• Rene Konga
• Yendoutie Konlani
• Gale Konrad
• Logan Andrew Konty, D.O.
• Christina Waiyin Koo, DO

• Acupuncturist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Acupuncturist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.