Individual provider Active NPI

Duoc Ung Chung, M.D.

  • Otolaryngology Physician
  • Winder, GA
National Provider Identifier
1306962592
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
64013 Issued in GA
Practice address
20 Satellite Drive
Suite 300
Winder, GA 30680
Phone
(678) 392-3913
Fax
(678) 815-1556
NPI assigned
Mar 21, 2007
Last updated
Jul 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 243336 NY
Otolaryngology Physician 207Y00000X 64013 GA Primary

Addresses

Primary practice location

20 Satellite Drive
Suite 300
Winder, GA 30680

Mailing address

4778 Ardmore Lane
Hoschton, GA 30548
Phone (404) 931-2133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000677 GA Practitioner - Otolaryngology 3971795741 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
64013GAMDOtolaryngology Physician
243336NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2010 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2010 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Mar 24, 2024 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Interoperability endpoints

  • Direct secure messaging: dchung@chung.mdlogic.direct-ci.com

Organizations & group practices 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1306962592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4778 ARDMORE LANE",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "30548",
            "telephone_number": "404-931-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SATELLITE DRIVE",
            "address_2": "SUITE 300",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "30680",
            "telephone_number": "678-392-3913",
            "fax_number": "678-815-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "DUOC",
        "middle_name": "UNG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "243336",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "64013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winder, GA

Sources for this page

Verify at the official NPI Registry.