Individual provider Active NPI

Kyungeun Jung

  • Physical Therapist
  • Cleveland, TN
National Provider Identifier
1215736400
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3112 Ocoee St N
Cleveland, TN 37312-5382
Phone
(423) 559-1537
Fax
(423) 559-1539
NPI assigned
Mar 10, 2025
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3112 Ocoee St N
Cleveland, TN 37312-5382

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250320001773 TN Practitioner - Physical Therapist in Private Practice 7911429824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCM Rehabilitation LLCGroup PAC ID 5294798336, 58 clinicians

Practice addresses (Care Compare)

3112 Ocoee St N
Cleveland, TN 37312-5382
Phone (423) 559-1537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MCM Rehabilitation, LLC. Physical Therapist CurrentSince Mar 10, 2025 Accepting new patients
MCM Rehabilitation LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

4947 Payshere Cir
Chicago, IL 60674

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

1808 Decatur Pike
Ste 20
Athens, TN 37303
Phone (423) 252-1637

3112 Ocoee St N
Cleveland, TN 37312
Phone (423) 554-1537

2125 Northpoint Blvd
Hixson, TN 37343
Phone (423) 875-3367

9408 Apison Pike
Ste 150
Ooltewah, TN 37363
Phone (423) 396-3004

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1215736400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 OCOEE ST N",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125382",
            "telephone_number": "423-559-1537",
            "fax_number": "423-559-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "KYUNGEUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.