Individual provider Active NPI

Avelyn Kwok, MD

  • Gastroenterology Physician
  • Charleston, SC
National Provider Identifier
1639457195
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MMD.34021LL Issued in SC
Practice address
25 Courtenay Dr
7100A, MSC 290
Charleston, SC 29425-8911
Phone
(843) 876-7226
Fax
(843) 876-4718
NPI assigned
Aug 1, 2011
Last updated
Aug 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MMD.34021LL SC Primary

Addresses

Primary practice location

25 Courtenay Dr
7100A, MSC 290
Charleston, SC 29425-8911

Mailing address

25 Courtenay Dr
7100A, MSC 290
Charleston, SC 29425-8911
Phone (843) 876-7226

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MMD.34021LLSCMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1639457195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 COURTENAY DR",
            "address_2": "7100A, MSC 290",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258911",
            "telephone_number": "843-876-7226",
            "fax_number": "843-876-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COURTENAY DR",
            "address_2": "7100A, MSC 290",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258911",
            "telephone_number": "843-876-7226",
            "fax_number": "843-876-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWOK",
        "first_name": "AVELYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "MMD.34021LL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.