Individual provider Active NPI

Renay Walker Chung, M.D.

  • Pediatrics Physician
  • Royal Palm Beach, FL
National Provider Identifier
1356393243
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D63775 Issued in MD
Practice address
11903 Southern Blvd Ste 118
Royal Palm Beach, FL 33411-7644
Phone
(561) 429-5898
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D63775 MD Primary

Addresses

Primary practice location

11903 Southern Blvd Ste 118
Royal Palm Beach, FL 33411-7644

Mailing address

11903 Southern Blvd
Royal Palm Beach, FL 33411-7644
Phone (561) 429-5898

Other names 1

  • Renay Anne-Marie Walker Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D63775MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Pediatrics Corp Pediatrics PastSince Oct 1, 2023 Accepting new patients
Vitalmd Group Holding LLC Pediatrics PastSince Oct 1, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1356393243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11903 SOUTHERN BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117644",
            "telephone_number": "561-429-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11903 SOUTHERN BLVD STE 118",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117644",
            "telephone_number": "561-429-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "RENAY",
        "middle_name": "WALKER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D63775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENAY",
            "last_name": "WALKER",
            "middle_name": "ANNE-MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.