Active NPI
Medplus Medical Group
- Internal Medicine Physician
- Fairfax, VA
National Provider Identifier
1710869581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MEDPLUS MEDICAL GROUP
- Practice address
- 10721 Main St Ste 204
Fairfax, VA 22030-6902 - Phone
- (571) 655-2267
- NPI assigned
- Jul 23, 2025
- Last updated
- Jul 23, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Myoungjoo Chung
- Title
- Director
- Phone
- (571) 655-2267
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NU | Primary |
Addresses
Primary practice location
10721 Main St Ste 204
Fairfax, VA 22030-6902
Mailing address
12584 Fair Village Way
Fairfax, VA 22033-6231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
10721 Main St
Ste 204
Fairfax, VA 22030
Phone (571) 414-0951
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753228800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753228800000",
"number": "1710869581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12584 FAIR VILLAGE WAY",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220336231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10721 MAIN ST STE 204",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220306902",
"telephone_number": "571-655-2267"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDPLUS MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-23",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A",
"authorized_official_last_name": "CHUNG",
"authorized_official_first_name": "MYOUNGJOO",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "571-655-2267"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"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 Jul 23, 2025; 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.