Individual provider Active NPI

Garrick Kaluen Kwok, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Duluth, GA
National Provider Identifier
1699971283
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
70162 Issued in GA
Practice address
3400 McClure Bridge Road
Building a, Suite B
Duluth, GA 30096
Phone
(678) 404-1140
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 70162 GA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 70162 GA Primary

Addresses

Primary practice location

3400 McClure Bridge Road
Building a, Suite B
Duluth, GA 30096

Mailing address

3400 McClure Bridge Road
Building a, Suite B
Duluth, GA 30096
Phone (678) 404-1140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160310000321 GA Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 6901040641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
University of Pittsburgh School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3400 McClure Bridge Rd
Suite B
Duluth, GA 30096-6675
Phone (770) 545-8421

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125583CAMDMental Health Counselor
70162GAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain and Spine Institute, LLC CurrentSince Apr 23, 2018 Accepting new patients

Locations

3400 McClure Bridge Rd
Bldg A
Duluth, GA 30096
Phone (678) 404-1140

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIDGBD
  • Direct secure messaging: garrick.kwok@25253881.chartlogic.direct-ci.com

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1699971283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MCCLURE BRIDGE ROAD",
            "address_2": "BUILDING A, SUITE B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-404-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MCCLURE BRIDGE ROAD",
            "address_2": "BUILDING A, SUITE B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-404-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWOK",
        "first_name": "GARRICK",
        "middle_name": "KALUEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "70162",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "70162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.