NPIMap

Individual provider Active NPI

Jae Kyung Chang, D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1528258704
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8594 Issued in AZ
Practice address
1240 116TH Ave NE
101
Bellevue, WA 98004-3815
Phone
(808) 393-4365
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8594 AZ Primary

Addresses

Primary practice location

1240 116TH Ave NE
101
Bellevue, WA 98004-3815

Mailing address

8863 W Lane Ave
Glendale, AZ 85305-3975
Phone (425) 985-8993

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

OrganizationSpecialtyStatusNew patients
Non Surgical Spine Care Center 1 PLLC Chiropractor Past Accepting new patients
Non-Surgical Spine Care Center Chiropractor Past Accepting new patients
Chang Family Chiropractic Chiropractor PastSince Nov 23, 2003 Accepting new patients

Organizations & group practices 3

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1528258704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8863 W LANE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053975",
            "telephone_number": "425-985-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 116TH AVE NE",
            "address_2": "101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043815",
            "telephone_number": "808-393-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JAE",
        "middle_name": "KYUNG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.