Organization Active NPI

Sung Yup Jung NP Inc

  • Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1578940243
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1629 Issued in HI
Legal business name
SUNG YUP JUNG NP INC
Practice address
1130 N Nimitz Hwy
153
Honolulu, HI 96817-4579
Phone
(808) 781-8046
Fax
(808) 536-8687
NPI assigned
May 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Sung Yup Jung, APRN
Title
Owner
Phone
(808) 781-8046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 1629 HI Primary

Addresses

Primary practice location

1130 N Nimitz Hwy
153
Honolulu, HI 96817-4579

Mailing address

1130 N Nimitz Hwy
153
Honolulu, HI 96817-4579
Phone (808) 781-8046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150624001733 HI Part B Supplier - Clinic/Group Practice 0446561989 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1130 N Nimitz Hwy
#153
Honolulu, HI 96817
Phone (808) 781-8046

1130 N Nimitz Hwy
Ste 153
Honolulu, HI 96817

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1578940243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N NIMITZ HWY",
            "address_2": "153",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174579",
            "telephone_number": "808-781-8046",
            "fax_number": "808-536-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N NIMITZ HWY",
            "address_2": "153",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174579",
            "telephone_number": "808-781-8046",
            "fax_number": "808-536-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNG YUP JUNG NP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "SUNG",
        "authorized_official_middle_name": "YUP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-781-8046",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "1629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.