Individual provider Active NPI

Jessica Chung, DNP, NP-C

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1538534722
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9307896 Issued in FL
Practice address
3246 Cove Bend Dr
Tampa, FL 33613-2752
Phone
(813) 775-6974
NPI assigned
Dec 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9307896 FL Primary

Addresses

Primary practice location

3246 Cove Bend Dr
Tampa, FL 33613-2752

Mailing address

3246 Cove Bend Dr
Tampa, FL 33613-2752
Phone (813) 530-5238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160510000011 FL Practitioner - Nurse Practitioner 6507155892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3246 Cove Bend Dr
Tampa, FL 33613-2752
Phone (813) 530-5238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9307896FLMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1538534722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3246 COVE BEND DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132752",
            "telephone_number": "813-530-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3246 COVE BEND DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132752",
            "telephone_number": "813-775-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9307896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.