NPIMap

Organization Active NPI

Dr. Edwin Jeung, OD, PC

  • Optometrist
  • Louisville, CO
National Provider Identifier
1194056663
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1094 Issued in CO
Legal business name
DR. EDWIN JEUNG, OD, PC
Practice address
1044 S 88TH St
Ste. 109
Louisville, CO 80027-9417
Phone
(303) 666-0104
NPI assigned
Jan 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Edwin Jeung, O.D.NPI 1033109483
Title
President
Phone
(303) 666-0104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1094 CO Primary

Addresses

Primary practice location

1044 S 88TH St
Ste. 109
Louisville, CO 80027-9417

Mailing address

1044 S 88TH St
Ste. 109
Louisville, CO 80027-9417
Phone (303) 666-0104

National Provider Directory

National Provider Directory

Locations

1044 S 88th St
Ste 109
Louisville, CO 80027
Phone (303) 665-9549

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1264204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1194056663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 S 88TH ST",
            "address_2": "STE. 109",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279417",
            "telephone_number": "303-666-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 S 88TH ST",
            "address_2": "STE. 109",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279417",
            "telephone_number": "303-666-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. EDWIN JEUNG, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-23",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "JEUNG",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-666-0104",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.