Active NPI
Kong Young Kwon, M.D.
- Psychiatry Physician
- Lorain, OH
National Provider Identifier
1700895885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35.037196
- Practice address
- 3700 Kolbe Rd
Lorain, OH 44053-1611 - Phone
- (440) 960-4000
- NPI assigned
- Aug 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35.037196 | OH | Primary |
Addresses
Primary practice location
3700 Kolbe Rd
Lorain, OH 44053-1611
Mailing address
578 N Leavitt Rd
C/O MMS
Amherst, OH 44001-1131
Phone (440) 988-1009
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2689863 | Medicaid | OH | |
| 2943917 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.037196 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chattree and Associates LTD | Past | Accepting new patients | |
| T Arthur-Mensah M D Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Beachwood, OH
- NPI 1962448654
-
- Clinical Neuropsychologist
- Sheffield Village, OH
- NPI 1447425186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254096000000",
"number": "1700895885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "578 N LEAVITT RD",
"address_2": "C/O MMS",
"city": "AMHERST",
"state": "OH",
"postal_code": "440011131",
"telephone_number": "440-988-1009",
"fax_number": "440-988-1225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 KOLBE RD",
"city": "LORAIN",
"state": "OH",
"postal_code": "440531611",
"telephone_number": "440-960-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "KONG",
"middle_name": "YOUNG",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-06",
"last_updated": "2009-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "35.037196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2689863",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2943917",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.