Active NPI
George F Wong III, MD
- Neurology Physician
- Rogersville, MO
National Provider Identifier
1508801333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- R7J28
- Practice address
- 3982 E Forrest Ridge LN
Rogersville, MO 65742-9293 - Phone
- (417) 886-8487
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | R7J28 | MO | Primary |
Addresses
Primary practice location
3982 E Forrest Ridge LN
Rogersville, MO 65742-9293
Mailing address
3982 E Forrest Ridge LN
Rogersville, MO 65742-9293
Phone (417) 886-8487
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107063 | Other | BLUE CROSS/BLUE SHIELD | |
| 202851200 | Medicaid | MO |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7J28 | MO | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferrell Duncan Clinic, Inc | Past | Accepting new patients | |
| Ozarks Medical Center | Neurology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Springfield, MO
- NPI 1326099383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1508801333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3982 E FORREST RIDGE LN",
"city": "ROGERSVILLE",
"state": "MO",
"postal_code": "657429293",
"telephone_number": "417-886-8487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3982 E FORREST RIDGE LN",
"city": "ROGERSVILLE",
"state": "MO",
"postal_code": "657429293",
"telephone_number": "417-886-8487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "GEORGE",
"middle_name": "F",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MO",
"license": "R7J28",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "107063",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202851200",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rogersville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.