Jisun Yi, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

01012488892 Issued in VA

Practice address

5800 Mapledale PLZ
Woodbridge, VA 22193-4535

Phone

(703) 670-0067

Fax

(703) 670-0301

NPI assigned

Apr 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jisun Oh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1689965683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 MAPLEDALE PLZ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934535",
            "telephone_number": "703-670-0067",
            "fax_number": "703-670-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 MAPLEDALE PLZ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934535",
            "telephone_number": "703-670-0067",
            "fax_number": "703-670-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "JISUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "01012488892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JISUN",
            "last_name": "OH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Endocrinology, Diabetes & Metabolism Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.