Individual provider Active NPI

Jung Eun Choi, DC

  • Chiropractor
  • Gaithersburg, MD
National Provider Identifier
1417246463
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03757 Issued in MD
Practice address
481 N Frederick Ave Ste 230
Gaithersburg, MD 20877-2471
Phone
(301) 527-1510
Fax
(301) 527-9320
NPI assigned
Mar 30, 2011
Last updated
May 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03757 MD Primary

Addresses

Primary practice location

481 N Frederick Ave Ste 230
Gaithersburg, MD 20877-2471

Mailing address

7049 Old Columbia Rd
Columbia, MD 21046-1728
Phone (703) 953-6555

Other identifiers 3

IdentifierTypeStateIssuer
765342OtherMDOPTUM HEALTH
765342OtherVAUNITED HEALTHCARE
K218-0018OtherVACAREFIRST BLUE CROSS BLUE SHIELD

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
S03757MDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1417246463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7049 OLD COLUMBIA RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461728",
            "telephone_number": "703-953-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 N FREDERICK AVE STE 230",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772471",
            "telephone_number": "301-527-1510",
            "fax_number": "301-527-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JUNG EUN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM HEALTH",
            "identifier": "765342",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "765342",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE SHIELD",
            "identifier": "K218-0018",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

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

Verify at the official NPI Registry.