Active NPI
Taesun Yeoum, D.C.
- Chiropractor
- Lower Gwynedd, PA
National Provider Identifier
1518938364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC008861
- Practice address
- 1600 N Bethlehem Pike
South Building S110
Lower Gwynedd, PA 19002-1427 - Phone
- (215) 628-0304
- Fax
- (215) 628-0306
- NPI assigned
- Jan 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC008861 | PA | Primary |
| Chiropractor | 111N00000X | 38MC00670700 | NJ |
Addresses
Primary practice location
1600 N Bethlehem Pike
South Building S110
Lower Gwynedd, PA 19002-1427
Mailing address
1600 N Bethlehem Pike
South Building Suite S110
Lower Gwynedd, PA 19002-1427
Phone (215) 628-0304
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2349132000 | Other | PA | IBC |
| 7827654 | Other | PA | AETNA |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kim Chiropractic & Rehab Center | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Philadelphia, PA
- NPI 1437180932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1518938364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 N BETHLEHEM PIKE",
"address_2": "SOUTH BUILDING SUITE S110",
"city": "LOWER GWYNEDD",
"state": "PA",
"postal_code": "190021427",
"telephone_number": "215-628-0304",
"fax_number": "215-628-0306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 N BETHLEHEM PIKE",
"address_2": "SOUTH BUILDING S110",
"city": "LOWER GWYNEDD",
"state": "PA",
"postal_code": "190021427",
"telephone_number": "215-628-0304",
"fax_number": "215-628-0306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEOUM",
"first_name": "TAESUN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-30",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC008861",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00670700",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "2349132000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7827654",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lower Gwynedd, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.