MARY KWON (NPI# 1790797645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790797645 |
| Entity Type | Individual |
| Full Name | MARY KWON |
| Credential | MD |
| Practice Address |
2550 University Ave W Suite 189s Saint Paul MN 55114-1052 |
| Practice Telephone | 6513327474 |
| Practice Fax Number | 6513327475 |
| Mailing Telephone | 6513327474 |
| Mailing Fax Number | 6513327475 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
27500 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS | 09128KW | 01 |
| MN | 357573000 | 05 | |
| MN | PREFERRED ONE | 376001 | 01 |
| MN | MEDICA | 23-08420 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295067999 | Mary Kwon | Physician Assistant | 1 Gustave Levy Pl., Mt. Sinai Medical Center, New York, NY 10029 | 2010-02-04 |
| Street Address |
2550 UNIVERSITY AVE W SUITE 189S |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396747143 | Colleen Rae Caspers | Nurse Practitioner | 2550 University Ave W, Suite 423 South, Saint Paul, MN 55114-1052 | 2005-08-11 |
| 1538707484 | Hannah Weaver | Nutritionist | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-12-11 |
| 1881251114 | Miriam Rebecca Koch Gerber | Psychologist | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-05-22 |
| 1578036042 | Sarah Lazarewicz | Social Worker | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-01-08 |
| 1215443049 | Frederick Marcus Vickery | Counselor | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2017-12-15 |
| 1790222438 | Plastic Surgery Consultants | Plastic Surgery | 2550 University Ave W, Ste 110n, Saint Paul, MN 55114-1052 | 2017-01-19 |
| 1720537350 | Kulule H Kenea | Nurse Practitioner | 2550 University Ave W, Suite 325s, Saint Paul, MN 55114-1052 | 2016-09-23 |
| 1992250187 | Erin Ziolkowski | Dietitian, Registered | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2016-08-17 |
| 1396196655 | Alyssa Greene | Counselor | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2016-06-28 |
| 1194174854 | Accessible Space, Inc. | Respite Care | 2550 University Ave W, Suite 330n, Saint Paul, MN 55114-1052 | 2016-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366886566 | Arcade Pain Center, P.l.l.c. | Physical Medicine & Rehabilitation | 651 Arcade St, Saint Paul, MN 55106-4518 | 2013-04-18 |
| 1548604846 | Kerri Wing-hun Chung | Physical Medicine & Rehabilitation | 295 Phalen Blvd, Saint Paul, MN 55130 | 2013-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760774665 | Matthew James Timp | Physical Medicine & Rehabilitation | 2300 24th St Nw Ste 101, Bemidji, MN 56601-6656 | 2011-05-10 |
| 1679863773 | Pain Relief and Wellness of Minnesota | Physical Medicine & Rehabilitation | 4721 Clark Ave, White Bear Lake, MN 55110-3221 | 2011-04-11 |
| 1407174790 | Catherine Y Choi | Physical Medicine & Rehabilitation | 3580 Arcade Ste Ste 100, Vadnais Heights, MN 55127-7135 | 2010-05-11 |
| 1073788519 | Isaac Thomas Marsolek | Physical Medicine & Rehabilitation | 401 Phalen Blved, St Paul, MN 55130-5302 | 2008-04-25 |
| 1457325540 | Adam J Locketz | Physical Medicine & Rehabilitation | 7275 147th St W, Apple Valley, MN 55124-7808 | 2006-02-15 |
| 1548253933 | Advanced Spine Associates Pa | Physical Medicine & Rehabilitation | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2005-08-31 |
| 1063414845 | David W Spight | Physical Medicine & Rehabilitation | 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 | 2005-08-11 |
| 1194259978 | Allina Health System | Physical Medicine & Rehabilitation | 913 E 26th St, Ste 503, Minneapolis, MN 55404-4515 | 2017-04-18 |
| 1861866816 | Sipple Medical LLC | Physical Medicine & Rehabilitation | 2020 E 28th St, Suite 100, Minneapolis, MN 55407-1394 | 2015-11-13 |
| 1184044067 | Sakshi Kaul | Physical Medicine & Rehabilitation | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2014-04-18 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.