Active NPI
Katherine Kwok-Mei Fong, M.D.
- Internal Medicine Physician
- Temple, TX
National Provider Identifier
1790768554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 78005
- Practice address
- 1901 Veterans Memorial Drive
Central Texas Veterans Healthcare - Ambulatory Care
Temple, TX 76504 - Phone
- (254) 742-4995
- Fax
- (254) 742-4681
- NPI assigned
- Nov 25, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 78005 | MA | Primary |
Addresses
Primary practice location
1901 Veterans Memorial Drive
Central Texas Veterans Healthcare - Ambulatory Care
Temple, TX 76504
Mailing address
112 Bella Vis
Georgetown, TX 78633-4496
Phone (254) 742-4995
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3112411 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120622000587 | TX | Order and Referring Only - Geriatric Medicine | 5193769008 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Massachusetts | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Worcester, MA
- NPI 1477618957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1790768554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 BELLA VIS",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786334496",
"telephone_number": "254-742-4995",
"fax_number": "254-742-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 VETERANS MEMORIAL DRIVE",
"address_2": "CENTRAL TEXAS VETERANS HEALTHCARE - AMBULATORY CARE",
"city": "TEMPLE",
"state": "TX",
"postal_code": "76504",
"telephone_number": "254-742-4995",
"fax_number": "254-742-4681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "KATHERINE",
"middle_name": "KWOK-MEI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-25",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "78005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3112411",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.