Individual provider Active NPI

Warren T Kwok, M.D.

  • Family Medicine Physician
  • Olive Branch, MS
National Provider Identifier
1760411813
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19093 Issued in MS
Practice address
8990 Germantown Rd
Olive Branch, MS 38654-8532
Phone
(662) 893-1160
Fax
(662) 893-1166
NPI assigned
Jul 1, 2006
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27217 TN
Family Medicine Physician 207Q00000X 19093 MS Primary

Addresses

Primary practice location

8990 Germantown Rd
Olive Branch, MS 38654-8532

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051201000671 MS Practitioner - Emergency Medicine 6901826221 Reassigns benefits to 1 organization
I20120424000127 TN Practitioner - Family Practice 6901826221 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19093MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Minor Medical Centers Inc Family Medicine CurrentSince Feb 4, 1997 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Past Accepting new patients
Baptist Memorial Medical Group Inc Family Medicine Past Accepting new patients

Locations

8990 Germantown Rd
Olive Branch, MS 38654
Phone (662) 893-1160

670 N Germantown Pkwy
Ste 18
Cordova, TN 38018
Phone (901) 753-7686

3295 Poplar Ave
Ste 105
Memphis, TN 38111
Phone (901) 327-8188

350 N Humphreys Blvd
Fl 4
Memphis, TN 38120
Phone (901) 227-0497

Interoperability endpoints

  • Direct secure messaging: wkwok3994@direct.bmhcc.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1760411813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 GERMANTOWN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548532",
            "telephone_number": "662-893-1160",
            "fax_number": "662-893-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWOK",
        "first_name": "WARREN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "27217",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.