Individual provider Active NPI

Jim Y. Chung, D.C., L.AC.

  • Sports Physician Chiropractor
  • Irvine, CA
National Provider Identifier
1487611067
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC29229 Issued in CA
Practice address
14785 Jeffrey Rd
Suite 102
Irvine, CA 92618-0408
Phone
(949) 857-2388
Fax
(949) 857-0198
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC29229 CA Primary
Sports Physician Chiropractor 111NS0005X B02002 NV
Acupuncturist 171100000X AC11395 CA

Addresses

Primary practice location

14785 Jeffrey Rd
Suite 102
Irvine, CA 92618-0408

Mailing address

14785 Jeffrey Rd
Suite 102
Irvine, CA 92618-0408
Phone (949) 857-2388

Other names 1

  • Dr. Jim Yung-Chun Chung Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060620000129 CA Practitioner - Chiropractic 5890707558 Practice locations: Irvine, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14785 Jeffrey Rd
Irvine, CA 92618-0409
Phone (949) 857-2388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC29229CAMDSports Physician Chiropractor
B02002NVMDSports Physician Chiropractor
AC11395CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Lin Chiropractic Professionals, Inc. Sports Physician Past Accepting new patients
Chang Chiropractic Corp Past 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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1487611067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14785 JEFFREY RD",
            "address_2": "SUITE 102",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180408",
            "telephone_number": "949-857-2388",
            "fax_number": "949-857-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14785 JEFFREY RD",
            "address_2": "SUITE 102",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180408",
            "telephone_number": "949-857-2388",
            "fax_number": "949-857-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JIM",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC29229",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NV",
            "license": "B02002",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIM",
            "last_name": "CHUNG",
            "middle_name": "YUNG-CHUN",
            "prefix": "DR.",
            "credential": "D.C., L.AC.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.