Individual provider Active NPI

Jiho Jung, L.AC.

  • Acupuncturist
  • Fairfax, VA
National Provider Identifier
1649444878
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
0121000502 Issued in VA
Practice address
10721 Main St
Suite G8
Fairfax, VA 22030-6914
Phone
(703) 383-9212
Fax
(703) 383-9214
NPI assigned
Apr 18, 2008
Last updated
Apr 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0121000502 VA Primary

Addresses

Primary practice location

10721 Main St
Suite G8
Fairfax, VA 22030-6914

Mailing address

10721 Main St
Suite G8
Fairfax, VA 22030-6914
Phone (703) 383-9212

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0121000502VAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Day Total Health Clinic PC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1649444878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE G8",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-383-9212",
            "fax_number": "703-383-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE G8",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-383-9212",
            "fax_number": "703-383-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "JIHO",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.