Individual provider Active NPI

Sophia Jung, PT, DPT, ATC

  • Pediatric Physical Therapist
  • Waconia, MN
National Provider Identifier
1396203055
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Practice address
9346 Oak Ave
Waconia, MN 55387-9422
Phone
(952) 223-2506
NPI assigned
Mar 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9346 Oak Ave
Waconia, MN 55387-9422

Mailing address

9346 Oak Ave
Waconia, MN 55387-9422

Other practice location 1

4530 Northern Sky Dr
Bismarck, ND 58503-8534
Phone (701) 255-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251113001114 MN Practitioner - Physical Therapist in Private Practice 3577092477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9346 Oak Ave
Waconia, MN 55387-9422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnydays Therapy Inc CurrentSince Nov 3, 2025 Accepting new patients
Pediatric Therapy Partners, Inc. CurrentSince Nov 20, 2024 Accepting new patients

Locations

15265 Minnetonka Blvd
Minnetonka, MN 55345

9346 Oak Ave
Waconia, MN 55387
Phone (952) 442-5812

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

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": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1396203055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9346 OAK AVE",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9346 OAK AVE",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879422",
            "telephone_number": "952-223-2506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4530 Northern Sky Dr",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585038534",
            "country_code": "US",
            "telephone_number": "701-255-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SOPHIA",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.