Individual provider Active NPI

Kam M Wong, PHD MD

  • Orthopaedic Surgery Physician
  • Sandusky, OH
National Provider Identifier
1528049376
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3554907 Issued in OH
Practice address
1401 Bone Creek Dr
Sandusky, OH 44870-7267
Phone
(419) 625-4900
Fax
(419) 626-8478
NPI assigned
Nov 9, 2005
Last updated
Nov 18, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 3554907 OH Primary

Addresses

Primary practice location

1401 Bone Creek Dr
Sandusky, OH 44870-7267

Mailing address

1401 Bone Creek Dr
Sandusky, OH 44870-7267
Phone (419) 625-4900

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, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3554907OHMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1528049376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BONE CREEK DR",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707267",
            "telephone_number": "419-625-4900",
            "fax_number": "419-626-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BONE CREEK DR",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707267",
            "telephone_number": "419-625-4900",
            "fax_number": "419-626-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KAM",
        "middle_name": "M",
        "credential": "PHD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "3554907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.