Individual provider Active NPI

David S Jung, D.C., L.AC.

  • Chiropractor
  • North Olmsted, OH
National Provider Identifier
1336143072
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3637 Issued in OH
Practice address
25566 Lorain Rd
North Olmsted, OH 44070-3322
Phone
(440) 777-7730
Fax
(440) 777-7727
NPI assigned
Jun 10, 2005
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3637 OH Primary
Acupuncturist 171100000X 65.000128 OH

Addresses

Primary practice location

25566 Lorain Rd
North Olmsted, OH 44070-3322

Mailing address

25566 Lorain Rd
North Olmsted, OH 44070-3322
Phone (440) 777-7730

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

LicenseStateTypeSpecialty
65.000128OHMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1336143072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25566 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703322",
            "telephone_number": "440-777-7730",
            "fax_number": "440-777-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25566 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703322",
            "telephone_number": "440-777-7730",
            "fax_number": "440-777-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3637",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OH",
            "license": "65.000128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Olmsted, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.