Johnson Wong

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2019012319 Issued in MO

Practice address

621 S New Ballas Rd Ste 112a
Creve Coeur, MO 63141-8252

Phone

(314) 251-6339

NPI assigned

Apr 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, 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

Specialty

Internal Medicine

Education

Meharry Medical College School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwong1032133@directc.mercy.net

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.

• Mercy Aco Clinical Services Inc

  • Neurology Physician
  • Chesterfield, MO
  • NPI 1063965093

  TN

  Medicare reassignment Care Compare group NPD
• Mercy Clinic Adult Hospitalists - Washington, LLC

  • Hospitalist Physician
  • Washington, MO
  • NPI 1891943429
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists- Jefferson, LLC

  • Internal Medicine Physician
  • Festus, MO
  • NPI 1083052492
  Medicare reassignment NPD
• Mercy Hospital Lincoln

  • Critical Access Hospital
  • Troy, MO
  • NPI 1962808733

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1861846909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 112A",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631418252",
            "telephone_number": "314-251-6339",
            "fax_number": "314-251-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 112A",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631418252",
            "telephone_number": "314-251-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JOHNSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2019012319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Chanel Winton, FNP - C
• Susan Wise, LPC
• Shelley Wolfmeyer, LPC
• Mildred Wolter
• Women's Health Specialists of St. Louis, LLC
• Matthew J. Woodyard, O.D.
• World Wide Neurology, LTD
• Allison Worrell
• Brittany Wort
• Sara E. Wright, PHD

• Internal Medicine Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.