NPIMap

Individual provider Active NPI

Kuna Tiga Fombutu Epse Okong, MD

  • Hospitalist Physician
  • Conway, AR
National Provider Identifier
1770014490
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
E13400 Issued in AR
Practice address
1700 Altus St
Conway, AR 72032-4289
Phone
(501) 513-5909
Fax
(501) 513-5257
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X E13400 AR Primary

Addresses

Primary practice location

1700 Altus St
Conway, AR 72032-4289

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Other practice location 1

1513 Cleveland Ave
Building 100, Suite 300 A
East Point, GA 30344-6947
Phone (404) 752-1000

Other names 1

  • Kuna Tiga Okong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200827003164 AR Practitioner - Hospitalist 8224303276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Regional Medical Center IncGroup PAC ID 3173428414, shared by 26 NPIs, 129 clinicians

Practice addresses (Care Compare)

437 Denison St
Conway, AR 72034-6127
Phone (501) 327-1325

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029
  • Ozark Health Hospital, Clinton, AR, CCN 041313

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center, Inc. Hospitalist CurrentSince Sep 1, 2020 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Sep 1, 2025 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Sep 1, 2020 Accepting new patients

Locations

437 Denison St
Ste 2
Conway, AR 72034
Phone (501) 504-2330

437 Denison St
Conway, AR 72034
Phone (501) 327-1325

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1770014490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-852-1363",
            "fax_number": "501-852-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ALTUS ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324289",
            "telephone_number": "501-513-5909",
            "fax_number": "501-513-5257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1513 Cleveland Ave",
            "address_2": "Building 100, Suite 300 A",
            "address_purpose": "LOCATION",
            "city": "East Point",
            "state": "GA",
            "postal_code": "303446947",
            "country_code": "US",
            "telephone_number": "404-752-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOMBUTU EPSE OKONG",
        "first_name": "KUNA TIGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E13400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KUNA",
            "last_name": "OKONG",
            "middle_name": "TIGA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.