Active NPI
Chan K Chung, M.D.
- Therapeutic Radiology Physician
- Takoma Park, MD
National Provider Identifier
1669455317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Therapeutic Radiology Physician
- License
- D27870
- Practice address
- 7600 Carroll Ave
C/O Washington Adventist Hospital
Takoma Park, MD 20912-6367 - Phone
- (301) 891-5100
- Fax
- (301) 891-5423
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Therapeutic Radiology Physician | 2085R0203X | D27870 | MD | Primary |
Addresses
Primary practice location
7600 Carroll Ave
C/O Washington Adventist Hospital
Takoma Park, MD 20912-6367
Mailing address
PO Box 1400
Fairfax, VA 22038-1400
Phone (703) 383-9543
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39968901 | Other | MD | CAREFIRST OF MD |
| 920001089 | Other | RR MEDICARE | |
| 65670001 | Other | DC | CAREFIRST OF DC |
| 258821800 | Medicaid | MD | |
| 023414900 | Medicaid | DC | |
| 65670001 | Other | DC | DC CAREFIRST |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1669455317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1400",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220381400",
"telephone_number": "703-383-9543",
"fax_number": "703-383-9532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 CARROLL AVE",
"address_2": "C/O WASHINGTON ADVENTIST HOSPITAL",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209126367",
"telephone_number": "301-891-5100",
"fax_number": "301-891-5423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "CHAN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0203X",
"taxonomy_group": "",
"desc": "Radiology, Therapeutic Radiology",
"state": "MD",
"license": "D27870",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST OF MD",
"identifier": "39968901",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "920001089",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST OF DC",
"identifier": "65670001",
"state": "DC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "258821800",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023414900",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DC CAREFIRST",
"identifier": "65670001",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.