Derek Shane Chung, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

2026016489 Issued in MO

Practice address

1229 E Seminole St
Springfield, MO 65804-2227

Phone

(417) 820-2064

NPI assigned

Mar 20, 2021

Last updated

Sep 2, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dchung754957@direct.med.utah.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment Care Compare group NPD
• University of Utah Acuity Care Services

  dba Anesthesiology Dept SICU

  • Critical Care Medicine (Anesthesiology) Physician
  • Salt Lake City, UT
  • NPI 1407250541
  Medicare reassignment NPD
• University of Utah Acuity Care Services

  dba U of U Neuro Critical Care

  • Neurological Surgery Physician
  • Salt Lake City, UT
  • NPI 1316341456
  NPD
• University of Utah Acuity Care Services

  dba Neurostimulation Adult Services

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1366804254
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Pulmonary Division

  • Pulmonary Disease Physician
  • Salt Lake City, UT
  • NPI 1093119893
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD

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

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1578149670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-2064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 S Grand Blvd # M260",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-977-1753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 N Mario Capechhi Dr RM 5N200",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "84112",
            "country_code": "US",
            "telephone_number": "801-581-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3125 Dr Russell Smith Way",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "MO",
            "postal_code": "648367402",
            "country_code": "US",
            "telephone_number": "417-359-1829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "448 State Highway 248",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656163725",
            "country_code": "US",
            "telephone_number": "417-820-2064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "DEREK",
        "middle_name": "SHANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-20",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "14209965-1204",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2026016489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard P Christy, MD
• Dalton L Chronister, PLPC
• Debby Chronister, SLP
• Chrysalis Wellness LLC
• Alexis Chum, IBCLC
• Church Therapy Associates, LLC
• Charles Church, HIS
• Kay Ann Ciaccio, MS
• Alyssa Susan Cicero, M.S., CCC-SLP
• Lisa Marie Cillessen, PHARMD, RPH

• Pain Medicine (Anesthesiology) Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Pain Medicine (Anesthesiology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.