NPIMap

Individual provider Active NPI

Nuree Kwon

  • Nurse Practitioner
  • Paso Robles, CA
National Provider Identifier
1629809967
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95031552 Issued in CA
Practice address
1355 Creston Rd Apt 306
Paso Robles, CA 93446-3092
Phone
(917) 774-0554
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11033819 FL
Nurse Practitioner 363L00000X 95031552 CA Primary

Addresses

Primary practice location

1355 Creston Rd Apt 306
Paso Robles, CA 93446-3092

Mailing address

1355 Creston Rd Apt 306
Paso Robles, CA 93446-3092
Phone (917) 774-0554

Other practice location 1

1304 Ella St Ste A
San Luis Obispo, CA 93401-4165
Phone (805) 549-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125000764 CA Practitioner - Nurse Practitioner 9436684677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1304 Ella St
Suite a
San Luis Obispo, CA 93401-4165
Phone (805) 549-9555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11033819FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Nov 25, 2024 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Nov 25, 2024 Accepting new patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

500 Old River Rd
Ste 200
Bakersfield, CA 93311
Phone (661) 663-6429

2901 N Ventura Rd
Ste 110
Oxnard, CA 93036
Phone (805) 981-6163

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

1304 Ella St
Ste A
Sn Luis Obisp, CA 93401
Phone (805) 541-1060

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1629809967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 CRESTON RD APT 306",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934463092",
            "telephone_number": "917-774-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 CRESTON RD APT 306",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934463092",
            "telephone_number": "917-774-0554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Ella St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934014165",
            "country_code": "US",
            "telephone_number": "805-549-9555",
            "fax_number": "805-549-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "NUREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11033819",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95031552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

Verify at the official NPI Registry.