Min Kwon, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

218621 Issued in AZ

Practice address

1145 Marina Blvd
Bullhead City, AZ 86442-5716

Phone

(928) 758-5905

Fax

(928) 758-8790

NPI assigned

Nov 13, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mohave Mental Health Clinic IncGroup PAC ID 7618963935, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Kingman, AZ
  • NPI 1902894272
  Medicare reassignment Care Compare group NPD
• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1316023864
  NPD
• Mohave Mental Health Clinic Inc

  • Community/Behavioral Health Agency
  • Kingman, AZ
  • NPI 1922275692
  NPD
• Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1508124488
  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1386113926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090507",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 MARINA BLVD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864425716",
            "telephone_number": "928-758-5905",
            "fax_number": "928-758-8790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2580 Hway 95 Ste 209",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864427330",
            "country_code": "US",
            "telephone_number": "928-758-5905",
            "fax_number": "928-758-1458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "218621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindred Smiles Family Dental
• Robert L Kistner Jr., M.D.
• Michelle A Klaumann, M.D.
• Vanna T. Klein, RDH
• Dorota Kotyra-Wright
• La Laser Center PC, a Professional Medical Corporation
• Laboratory Corporation of America
• Ashley Ann Laflamme, LMSW
• Lakeside Orthopedic Institute, LLC
• Frederick Brock Lamb, DDS

• Psychiatric/Mental Health Nurse Practitioner in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.