Functional Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2862 Issued in MA

Legal business name

FUNCTIONAL CHIROPRACTIC, INC.

Practice address

126 Merrimack St
Methuen, MA 01844-6109

Phone

(781) 244-7301

NPI assigned

Jan 7, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jin Woo Sung, DCNPI 1962514786

Title

President

Phone

(978) 688-6999

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jin Woo Sung, DC

  • Chiropractor
  • Methuen, MA
  • NPI 1962514786
  Medicare reassignment NPD Authorized official
• Melissa Erin Carroll, PT

  • Physical Therapist
  • Methuen, MA
  • NPI 1417164948
  NPD (past)
• Joanne Mary Lyson, PT

  • Physical Therapist
  • Lowell, MA
  • NPI 1235222019
  NPD (past)
• Robert M. Scaccia I, PT

  • Physical Therapist
  • Windham, NH
  • NPI 1225073679
  NPD (past)

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1487890802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MERRIMACK ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018446109",
            "telephone_number": "978-688-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MERRIMACK ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018446109",
            "telephone_number": "781-244-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "SUNG",
        "authorized_official_first_name": "JIN",
        "authorized_official_middle_name": "WOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-688-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Frederique
• Caitlin Fredette
• Fudge Chiropractic & Wellness LLC
• Deborah Anne Fudge, D.C.
• O'Lyvia Fuller
• Natalie Fung, MS
• Gerald A Gaglione, ATC, LAT
• Jennifer Lynn Gagnon, RN
• Mary Josephine Gallant, RN
• Kristin Fitzgerald Galvin, LICSW

• Chiropractor in Methuen, MA
• Providers in Methuen, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.