Individual provider Active NPI

Jeong Wook Yun, OMD

  • Acupuncturist
  • Ellicott City, MD
National Provider Identifier
1659864015
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U02477 Issued in MD
Practice address
3448 Ellicott Center Dr Ste 103
Ellicott City, MD 21043-4668
Phone
(443) 765-2007
NPI assigned
Jun 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U02477 MD Primary

Addresses

Primary practice location

3448 Ellicott Center Dr Ste 103
Ellicott City, MD 21043-4668

Mailing address

13020 Triadelphia Rd
Ellicott City, MD 21042-1124
Phone (443) 765-2007

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
U02477MDMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1659864015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 TRIADELPHIA RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421124",
            "telephone_number": "443-765-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3448 ELLICOTT CENTER DR STE 103",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434668",
            "telephone_number": "443-765-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUN",
        "first_name": "JEONG",
        "middle_name": "WOOK",
        "credential": "OMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.