Active NPI
Haerim Kwon Pak, NP
- Women's Health Nurse Practitioner
- Bedford, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 71017394A
- Practice address
- 2900 16TH St
Bedford, IN 47421-3510 - Phone
- (812) 275-5993
- NPI assigned
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 0033230 | OH | |
| Women's Health Nurse Practitioner | 363LW0102X | 71017394A | IN | Primary |
Addresses
Primary practice location
2900 16TH St
Bedford, IN 47421-3510
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-5252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300125262 | Medicaid | IN |
Other names 1
- Haerim Kwon
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | HKWON@DIRECT.IUHEALTH.ORG | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2900 16TH St
Bedford, IN 47421-3510
Phone (888) 484-3258
Hospital & facility affiliations
- Indiana University Health Bloomington Hospital
- Indiana University Health Bedford Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71017394A | IN | MD | Women's Health Nurse Practitioner |
| 0033230 | OH | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Current | Accepting new patients |
Locations
2900 16th St
Bedford, IN 47421
Phone (812) 275-1200
2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
Interoperability endpoints
- hkwon@direct.iuhealth.org
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Bedford, IN
- NPI 1548260284
-
- General Acute Care Hospital
- Bloomington, IN
- NPI 1205860335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1457051625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 16TH ST",
"city": "BEDFORD",
"state": "IN",
"postal_code": "474213510",
"telephone_number": "812-275-5993"
}
],
"practiceLocations": [
{
"address_1": "2651 E Discovery Pkwy",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "IN",
"postal_code": "474089059",
"country_code": "US",
"telephone_number": "812-353-5252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAK",
"first_name": "HAERIM",
"middle_name": "KWON",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-07",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OH",
"license": "0033230",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IN",
"license": "71017394A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300125262",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "HKWON@DIRECT.IUHEALTH.ORG",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2900 16th St",
"city": "Bedford",
"state": "IN",
"country_code": "US",
"postal_code": "474213510",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "HAERIM",
"last_name": "KWON",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bedford, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.