Ichabod S Jung, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

220355 Issued in NY

Practice address

117 Foote Ave
Suite 100
Jamestown, NY 14701-6947

Phone

(716) 338-9200

Fax

(716) 338-9250

NPI assigned

Jul 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: drjung@qualitycare.medentdirect.com

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296691200000",
    "number": "1497784789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 FOOTE AVE",
            "address_2": "SUITE 100",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016947",
            "telephone_number": "716-338-9200",
            "fax_number": "716-338-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FOOTE AVE",
            "address_2": "SUITE 100",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016947",
            "telephone_number": "716-338-9200",
            "fax_number": "716-338-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "ICHABOD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2011-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "220355",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD417045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2163913",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylah Taneal Jones, RN
• Jessica L Jonesford, PTA
• Linda Rose Jordan, MD
• Harris Tom Joseph, M.D.
• Jacqueline A. Joy, LMSW
• Olivia Marie Kaltenbach
• Lioudmila Kaminiar, M.D.
• Pamela R Kanicki, PTA
• Neeru Kapur
• Mumtaz Karimi, MD

• Urology Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.