Tae Jung M.D., Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35078382J Issued in OH

Legal business name

TAE JUNG M.D., INC.

Practice address

15424 Sprucevale Rd
East Liverpool, OH 43920-9200

Phone

(330) 382-0388

Fax

(330) 382-0389

NPI assigned

Jan 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Tae Hui Jung, M.D.NPI 1831153006

Title

President

Phone

(330) 382-0388

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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.

• Tae H Jung, M.D.

  • Family Medicine Physician
  • East Liverpool, OH
  • NPI 1831153006
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1306021878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15424 SPRUCEVALE RD",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439209200",
            "telephone_number": "330-382-0388",
            "fax_number": "330-382-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15424 SPRUCEVALE RD",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439209200",
            "telephone_number": "330-382-0388",
            "fax_number": "330-382-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAE JUNG M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "TAE",
        "authorized_official_middle_name": "HUI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-382-0388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35078382J",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1306021878",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "SP00791",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2205527",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Swain, M.D.
• Lee B Swearingen, DDS
• Mark William Swift, DO
• Robert B. Sylvies, PSY.D
• Katherine Szymanski, MOT, OTR/L
• Kelly Talkington
• Danielle Tanielian, DO
• Liza Marie Tanner
• Patricia Taylor Smith, LPC
• Patricia Taylor, LPCC-S

• Family Medicine Physician in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.