Individual provider Active NPI

Kau-Wun Chang, MD

  • Emergency Medicine Physician
  • Middleburg Heights, OH
National Provider Identifier
1780624379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35040164 Issued in OH
Practice address
18697 Bagley Rd
Middleburg Heights, OH 44130-3417
Phone
(440) 816-8000
NPI assigned
Jun 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35040164 OH Primary

Addresses

Primary practice location

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Mailing address

347 Front St
Berea, OH 44017-1771

Other identifiers 1

IdentifierTypeStateIssuer
942460636905OtherOHCARESOURCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160210000833 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5698079754

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35040164OHMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780624379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 FRONT ST",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KAU-WUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35040164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636905",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.