NPIMap

Individual provider Active NPI

Jung Yeon Kwon

  • Obstetrics & Gynecology Physician
  • Georgetown, TX
National Provider Identifier
1760010458
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
V1522 Issued in TX
Practice address
1900 Scenic Dr Ste 3326
Georgetown, TX 78626-7876
Phone
(877) 800-5722
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X V1522 TX Primary

Addresses

Primary practice location

1900 Scenic Dr Ste 3326
Georgetown, TX 78626-7876

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Other practice location 1

1430 Tulane Ave # 8611
New Orleans, LA 70112-2632
Phone (504) 988-5216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240822002422 TX Practitioner - Obstetrics/Gynecology 7517406572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tulane University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Circle of Care 29 clinicians

Practice addresses (Care Compare)

2423 Williams Dr
Georgetown, TX 78628-3200
Phone (877) 800-5722

Hospital & facility affiliations

  • St David'S Medical Center Hospital, Austin, TX, CCN 450431

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V1522TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Circle of Care CurrentSince Sep 9, 2024 Accepting new patients
Lone Star Circle of Care CurrentSince Sep 9, 2024 Accepting new patients
Lone Star Circle of Care Obstetrics & Gynecology Current Accepting new patients
St. Davids Healthcare Partnership, L.P., LLP Past Accepting new patients
Lone Star Circle of Care Past Accepting new patients

Locations

1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249

2423 Williams Dr
Georgetown, TX 78628
Phone (512) 341-8908

205 E University Ave
Ste 200
Georgetown, TX 78626
Phone (512) 686-0207

1900 Scenic Dr
Ste 3326
Georgetown, TX 78626
Phone (512) 863-6850

2423 Williams Dr
Ste 107
Georgetown, TX 78628
Phone (512) 686-0207

Interoperability endpoints

  • Direct secure messaging: jung.yeon.kwon.1@29821.direct.athenahealth.com

Organizations & group practices 24

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.

View all 24

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1760010458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DR STE 3326",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267876",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave # 8611",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-5216",
            "fax_number": "504-988-1846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "JUNG YEON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "V1522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.