Individual provider Active NPI

PO Lin Chung, RN

  • Registered Nurse
  • Salt Lake City, UT
National Provider Identifier
1720394265
Registry record updated Aug 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
5228785-3102 Issued in UT
Practice address
149 Perth PL
Salt Lake City, UT 84115-5007
Phone
(801) 261-3953
NPI assigned
Aug 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 5228785-3102 UT Primary

Addresses

Primary practice location

149 Perth PL
Salt Lake City, UT 84115-5007

Mailing address

149 Perth PL
Salt Lake City, UT 84115-5007
Phone (801) 261-3953

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
5228785-3102UTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1282435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282435200000",
    "number": "1720394265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 PERTH PL",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155007",
            "telephone_number": "801-261-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 PERTH PL",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155007",
            "telephone_number": "801-261-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "PO LIN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-22",
        "last_updated": "2010-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "5228785-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2010; 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.