Active NPI
Younghyun Grace Oh, M.D.
- Ophthalmology Physician
- Jackson, MS
National Provider Identifier
1184883316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 19544
- Practice address
- 1200 N State St Ste 330
Jackson, MS 39202 - Phone
- (601) 353-2020
- Fax
- (601) 714-5110
- NPI assigned
- Jun 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 19544 | MS | Primary |
| Ophthalmology Physician | 207W00000X | G61324 | CA |
Addresses
Primary practice location
1200 N State St Ste 330
Jackson, MS 39202
Mailing address
1200 N State St Ste 330
Jackson, MS 39202-2027
Phone (601) 353-2020
Other practice location 1
1190 N State St
Suite 403
Jackson, MS 39202-2413
Phone (601) 353-2020 ext. 138
Other practice location 2
1190 N State St
Suite 403
Jackson, MS 39202-2413
Phone (601) 353-2020 ext. 138
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04323208 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G61324 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552867200000",
"number": "1184883316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N STATE ST STE 330",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022027",
"telephone_number": "601-353-2020",
"fax_number": "601-714-5110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST STE 330",
"city": "JACKSON",
"state": "MS",
"postal_code": "39202",
"telephone_number": "601-353-2020",
"fax_number": "601-714-5110"
}
],
"practiceLocations": [
{
"address_1": "1190 N State St",
"address_2": "Suite 403",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392022413",
"country_code": "US",
"telephone_number": "601-353-2020 x138",
"fax_number": "601-714-5110",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1190 N State St",
"address_2": "Suite 403",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392022413",
"country_code": "US",
"telephone_number": "601-353-2020 x138",
"fax_number": "601-714-5110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OH",
"first_name": "YOUNGHYUN",
"middle_name": "GRACE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2019-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MS",
"license": "19544",
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "G61324",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04323208",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.