Individual provider Active NPI

Jung Suh, O.D.

  • Optometrist
  • Warrenton, VA
National Provider Identifier
1245406842
Registry record updated Jun 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001516 Issued in VA
Practice address
8278 James Madison Hwy
Warrenton, VA 20186-3818
Phone
(540) 351-0125
NPI assigned
May 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001516 VA Primary

Addresses

Primary practice location

8278 James Madison Hwy
Warrenton, VA 20186-3818

Mailing address

8278 James Madison Hwy
Warrenton, VA 20186-3818
Phone (540) 351-0125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120910000806 VA Practitioner - Optometry 3173771516 Reassigns benefits to 1 organization
I20160706000848 DC Practitioner - Optometry 3173771516 Reassigns benefits to 1 organization
Practice locations: Annandale, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001516VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Jul 1, 2016 Accepting new patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Jul 1, 2016 Accepting new patients
Nova Premier Eyecare, P.C. Optometrist PastSince Sep 13, 2010 Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients
Wal-Mart Stores East LP Past Accepting new patients

Locations

11130L South Lakes Dr
Reston, VA 20191
Phone (703) 471-1012

2700 Potomac Mills Cir
Ste 105
Woodbridge, VA 22192
Phone (703) 494-0660

Organizations & group practices 5

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": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338681600000",
    "number": "1245406842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8278 JAMES MADISON HWY",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863818",
            "telephone_number": "540-351-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8278 JAMES MADISON HWY",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863818",
            "telephone_number": "540-351-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "JUNG",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2012-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.