Individual provider Active NPI

Cheri L Jung, DC

  • Chiropractor
  • Ottawa, KS
National Provider Identifier
1043329295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-04290 Issued in KS
Practice address
1501 S Main St
Ottawa, KS 66067-3802
Phone
(785) 242-4100
Fax
(785) 242-4121
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-04290 KS Primary

Addresses

Primary practice location

1501 S Main St
Ottawa, KS 66067-3802

Mailing address

1501 S Main St
Ottawa, KS 66067-3802
Phone (785) 242-4100

Other identifiers 4

IdentifierTypeStateIssuer
15736OtherKSCOVENTRY
5888504OtherKSAETNA
014268OtherKSBLUE CROSS BLUE SHIELD OF
44-00193OtherKSUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405000213 KS Practitioner - Chiropractic 3072560812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ottawa Chiropractic Clinic PAGroup PAC ID 8628025475, 2 clinicians

Practice addresses (Care Compare)

1501 S Main St
Ottawa, KS 66067-3802
Phone (785) 242-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-04290KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa Chiropractic Clinic PA Chiropractor CurrentSince Dec 1, 1995 Accepting new patients

Locations

1501 S Main St
Ottawa, KS 66067
Phone (785) 242-4100

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043329295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673802",
            "telephone_number": "785-242-4100",
            "fax_number": "785-242-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673802",
            "telephone_number": "785-242-4100",
            "fax_number": "785-242-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CHERI",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "15736",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5888504",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "014268",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "44-00193",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.