Nepenthe Irwin Fong, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD60441577 Issued in WA

Practice address

2825 Oak Lawn Ave Unit 300309
Dallas, TX 75219-4102

Phone

(844) 389-5711

Fax

(877) 880-2039

NPI assigned

Oct 31, 2006

Last updated

Sep 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, TX2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ideal MRI, LLC

  • Radiology Clinic/Center
  • Waco, TX
  • NPI 1932692548

  WA

  Medicare reassignment NPD
• Midtown Medical Imaging - Alliance

  • Radiology Clinic/Center
  • Fort Worth, TX
  • NPI 1629527312
  NPD
• Midtown Medical Imaging - Southlake, LLC

  • Radiology Clinic/Center
  • Southlake, TX
  • NPI 1023683307
  NPD
• Midtown Medical Imaging Limited

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Fort Worth, TX
  • NPI 1972937027
  NPD
• Ramic Fort Worth, LLC

  • Radiology Clinic/Center
  • Fort Worth, TX
  • NPI 1871788224
  NPD
• East Texas Radiology Consultants

  • Diagnostic Radiology Physician
  • Longview, TX
  • NPI 1174580138
  NPD (past)
• Cira Michigan PC

  • Diagnostic Radiology Physician
  • Escanaba, MI
  • NPI 1972141513
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• University Radiologists Inc

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1518917442
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1922185875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 OAK LAWN AVE UNIT 192749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194688",
            "telephone_number": "510-683-9500",
            "fax_number": "877-880-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 OAK LAWN AVE UNIT 300309",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194102",
            "telephone_number": "844-389-5711",
            "fax_number": "877-880-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "NEPENTHE",
        "middle_name": "IRWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "66519",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "54598",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "TP637",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R9353",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60441577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A762640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Folse, M.D.
• Yevgenia Fomina, MD
• Edmond Nketti Fomunung, MD
• Leanne Fondren, LPC
• Benton Dodwah Fong, MD
• Thomas Fong, DMD
• Yolanda Erika Fong, MD
• Elodie Fongang Mafo
• Solange Ajua Fonkem
• Quinta Fonkwa

• Diagnostic Radiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.

Verify at the official NPI Registry.