Individual provider Active NPI

Carolyn Hayes Wong, MD

  • Emergency Medicine Physician
  • Show Low, AZ
National Provider Identifier
1316203235
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
76771 Issued in AZ
Practice address
2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone
(928) 537-4375
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2025-0565 NM
Emergency Medicine Physician 207P00000X 76771 AZ Primary

Addresses

Primary practice location

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310

Other practice location 1

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-5062

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA, AZ, NM4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20210113000760 TX Practitioner - Emergency Medicine 0143532333 Reassigns benefits to 1 organization
I20241210004623 CA Practitioner - Emergency Medicine 0143532333
I20250514000390 AZ Practitioner - Emergency Medicine 0143532333 Reassigns benefits to 1 organization
I20250705000083 NM Practitioner - Emergency Medicine 0143532333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76771AZMDEmergency Medicine Physician
MD2025-0565NMMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group Inc CurrentSince Jun 25, 2025 Accepting new patients
Innova Emergency Medical Associates PC Emergency Medicine CurrentSince May 5, 2025 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Oct 10, 2020 Accepting new patients
Unm Medical Group, Inc. CurrentSince Jun 25, 2025 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

9878 W Belleview Ave
Littleton, CO 80123
Phone (303) 978-1316

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: cwong696493@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 5

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1316203235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-4375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871062719",
            "country_code": "US",
            "telephone_number": "505-272-5062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "CAROLYN",
        "middle_name": "HAYES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2025-0565",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "76771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.