Individual provider Active NPI

Kimberly Ann Wong, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1902547516
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8059 Issued in OK
Practice address
8921 S Mingo Rd
Tulsa, OK 74133-5841
Phone
(918) 252-8000
NPI assigned
Apr 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8059 OK Primary

Addresses

Primary practice location

8921 S Mingo Rd
Tulsa, OK 74133-5841

Mailing address

8921 S Mingo Rd
Tulsa, OK 74133-5841
Phone (918) 252-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20250916003877 OK Order and Referring Only - Family PracticePractitioner - Family Practice 5092219782

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St John Urgent Care Clinics Inc PastSince Apr 10, 2022 Accepting new patients
St. John Physicians, Inc. Family Medicine PastSince Apr 10, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kimberly.wong.1@20767.direct.athenahealth.com

Organizations & group practices 2

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1902547516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 S MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335841",
            "telephone_number": "918-252-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 S MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335841",
            "telephone_number": "918-252-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "8059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.