Individual provider Active NPI

Robert Kwan, APRN

  • Family Nurse Practitioner
  • Canton, NC
National Provider Identifier
1730732587
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11002949 Issued in FL
Practice address
55 Buckeye Cove Rd
Canton, NC 28716-4511
Phone
(727) 480-6116
NPI assigned
Jul 22, 2019
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11002949 FL Primary

Addresses

Primary practice location

55 Buckeye Cove Rd
Canton, NC 28716-4511

Mailing address

4905 Manor Dr
New Port Richey, FL 34652-6159
Phone (727) 480-6116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000481 NC Practitioner - Nurse Practitioner 7911394838 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

262 Leroy George Dr
Clyde, NC 28721-7430
Phone (800) 424-3672

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11002949FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Haywood Regional Medical Center LLC CurrentSince Jan 15, 2022 Accepting new patients
Southeastern Emergency Physicians LLC CurrentSince Apr 1, 2024 Accepting new patients
DLP Haywood Regional Medical Center LLC CurrentSince Jan 15, 2022 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Dec 1, 2024 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

55 Buckeye Cove Rd
Canton, NC 28716
Phone 8284525042136

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

556 Hazelwood Ave
Waynesville, NC 28786
Phone (828) 452-8890

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: robert.kwan.2@9865.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1730732587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 MANOR DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346526159",
            "telephone_number": "727-480-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BUCKEYE COVE RD",
            "city": "CANTON",
            "state": "NC",
            "postal_code": "287164511",
            "telephone_number": "727-480-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAN",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NC

Sources for this page

Verify at the official NPI Registry.