Individual provider Active NPI

Sangwon Jung, DC

  • Chiropractor
  • Bethesda, MD
National Provider Identifier
1326150194
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
502086 Issued in MD
Practice address
9020 Old Georgetown Rd
Bethesda, MD 20814-1514
Phone
(301) 468-3434
Fax
(240) 223-2502
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 502086 MD Primary

Addresses

Primary practice location

9020 Old Georgetown Rd
Bethesda, MD 20814-1514

Mailing address

9020 Old Georgetown Rd
Bethesda, MD 20814-1514
Phone (301) 468-3434

Other identifiers 4

IdentifierTypeStateIssuer
G7310001OtherDCCAREFIRST BCBS
404059700MedicaidMD
KDN25AOtherMDCAREFIRST BCBS
617750OtherMDCAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
502086MDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1326150194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 OLD GEORGETOWN RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141514",
            "telephone_number": "301-468-3434",
            "fax_number": "240-223-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 OLD GEORGETOWN RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141514",
            "telephone_number": "301-468-3434",
            "fax_number": "240-223-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SANGWON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "502086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "G7310001",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404059700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "KDN25A",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "617750",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.