Individual provider Active NPI

Sae Jeong

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1457195877
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024190174 Issued in VA
Practice address
2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone
(540) 510-6200
NPI assigned
Jun 20, 2024
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024190174 VA Primary

Addresses

Primary practice location

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5353

Other practice location 1

2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone (540) 981-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016001106 VA Practitioner - Nurse Practitioner 7618409640 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024190174VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Franklin Memorial Hospital CurrentSince Sep 30, 2024 Accepting new patients
Carilion Medical Center CurrentSince Sep 30, 2024 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Sep 30, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Sep 30, 2024 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Sep 30, 2024 Accepting new patients
Carilion Medical Center CurrentSince Sep 30, 2024 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Sep 30, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Sep 30, 2024 Accepting new patients

Locations

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

2331 Franklin Rd SW
Roanoke, VA 24014
Phone (540) 725-1226

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

Interoperability endpoints

  • Direct secure messaging: sjeong184542@direct.carilionclinic.org

Organizations & group practices 8

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1457195877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-510-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2331 Franklin Rd SW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141111",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEONG",
        "first_name": "SAE",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024190174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.