Ethan Sungeun Yun, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

2018-01099 Issued in NC

Practice address

1219 Lexington Ave Ste B
Thomasville, NC 27360-2784

Phone

(336) 481-1880

NPI assigned

Apr 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Neurology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085
• Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eyun722710@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Coastal Plastic Surgery

  • Plastic Surgery Physician
  • Southport, NC
  • NPI 1538578174
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Medical Park Hospital LLC

  dba Novant Health Medical Park Hospital

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1538111828
  Care Compare affiliation
• Novant Health Thomasville Medical Center, LLC

  dba Novant Health Thomasville Medical Center

  • General Acute Care Hospital
  • Thomasville, NC
  • NPI 1801848767
  Care Compare affiliation

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1063831907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-277-2200",
            "fax_number": "336-277-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 LEXINGTON AVE STE B",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273602784",
            "telephone_number": "336-481-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Frontis Plaza Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-277-2200",
            "fax_number": "336-277-2210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2025 Frontis Plaza Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-277-2200",
            "fax_number": "336-277-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUN",
        "first_name": "ETHAN",
        "middle_name": "SUNGEUN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2018-01099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eyun722710@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2025 Frontis Plaza Blvd Ste 120",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blane Wesley Yelton Jr.
• Melissa Carmichael York
• Theresa Cundari York, PNP
• Samantha Danielle Young, EMT-PARAMEDIC
• Sandra Lynn Youse
• Gerald Michael Zupruk, MD

• Neurology Physician in Thomasville, NC
• Providers in Thomasville, NC by specialty
• Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.
• 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.