Individual provider Active NPI

Susan Soo Jung, NP-C

  • Adult Health Nurse Practitioner
  • Solon, OH
National Provider Identifier
1316180797
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A0309151 Issued in CA
Practice address
29800 Bainbridge Rd
Solon, OH 44139-2202
Phone
(440) 519-6800
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A0309151 CA Primary

Addresses

Primary practice location

29800 Bainbridge Rd
Solon, OH 44139-2202

Mailing address

29800 Bainbridge Rd
Solon, OH 44139-2202
Phone (440) 519-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000761 OH Practitioner - Nurse Practitioner 5193990919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

5700 Cooper Foster Park Rd W
Lorain, OH 44053-4152
Phone (440) 204-7400

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A0309151CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Oct 25, 2011 Accepting new patients

Locations

551 Washington St
Chagrin Falls, OH 44022
Phone (440) 893-9393

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

29800 Bainbridge Rd
Solon, OH 44139
Phone (440) 519-6800

Interoperability endpoints

  • Direct secure messaging: sjung147518@direct.ccf.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1316180797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29800 BAINBRIDGE RD",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392202",
            "telephone_number": "440-519-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29800 BAINBRIDGE RD",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392202",
            "telephone_number": "440-519-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SUSAN",
        "middle_name": "SOO",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "A0309151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

Verify at the official NPI Registry.