Individual provider Active NPI

Katherine Kwok-Mei Fong, M.D.

  • Internal Medicine Physician
  • Temple, TX
National Provider Identifier
1790768554
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
78005 Issued in MA
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

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3112411MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120622000587 TX Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 5193769008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.