Individual provider Active NPI

Shun C Kwong, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Omaha, NE
National Provider Identifier
1558318725
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
20529 Issued in NE
Practice address
6901 N 72ND St
Omaha, NE 68122-1799
Phone
(402) 572-2225
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 20529 NE Primary

Addresses

Primary practice location

6901 N 72ND St
Omaha, NE 68122-1799

Mailing address

PO Box 31058
Omaha, NE 68131-0058
Phone (866) 898-7142

Other identifiers 1

IdentifierTypeStateIssuer
30632OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110001050 NE Practitioner - Emergency Medicine 0547283095 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20529NEMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Clinicians Associates, LLC Emergency Medical Services CurrentSince Aug 1, 2002 Accepting new patients

Locations

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1558318725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31058",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681310058",
            "telephone_number": "866-898-7142",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 N 72ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221799",
            "telephone_number": "402-572-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "SHUN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NE",
            "license": "20529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30632",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.