Active NPI
Michelle Linae Jung, MPT
- Physical Therapist
- Jordan, MN
National Provider Identifier
1326410341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6393
- Practice address
- 622 Aberdeen Ave
Jordan, MN 55352-9516 - Phone
- (952) 492-5559
- NPI assigned
- Oct 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6393 | MN | Primary |
Addresses
Primary practice location
622 Aberdeen Ave
Jordan, MN 55352-9516
Mailing address
7942 Hamilton Rd
Savage, MN 55378-3501
Phone (952) 334-6806
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6393 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446076800000",
"number": "1326410341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7942 HAMILTON RD",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553783501",
"telephone_number": "952-334-6806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 ABERDEEN AVE",
"city": "JORDAN",
"state": "MN",
"postal_code": "553529516",
"telephone_number": "952-492-5559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "MICHELLE",
"middle_name": "LINAE",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-29",
"last_updated": "2015-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "6393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jordan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.