Individual provider Active NPI

Gar Win Chung, D.O.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1013147099
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
SL0649 Issued in NV
Practice address
620 Shadow Lane
Las Vegas, NV 89106-4194
Phone
(702) 388-8436
Fax
(702) 388-8431
NPI assigned
Jul 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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 SL0649 NV Primary

Addresses

Primary practice location

620 Shadow Lane
Las Vegas, NV 89106-4194

Mailing address

620 Shadow Lane
Las Vegas, NV 89106-4194
Phone (702) 388-8436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20120605000640 NV Practitioner - Internal Medicine 8729242631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9300 W Sunset Rd
Las Vegas, NV 89148-4844
Phone (702) 450-1717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SL0649NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
GWC DO PC Internal Medicine CurrentSince Jun 1, 2012 Accepting new patients

Locations

8280 W Warm Springs Rd
Las Vegas, NV 89113
Phone (702) 458-5099

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

3022 S Durango Dr
Ste 100
Las Vegas, NV 89117
Phone (702) 210-9423

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1013147099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SHADOW LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-8436",
            "fax_number": "702-388-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-8436",
            "fax_number": "702-388-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "GAR",
        "middle_name": "WIN",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "SL0649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.