Individual provider Active NPI

Kihyuk Roy Jung, D.C

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1730576794
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60539446 Issued in WA
Practice address
13751 Lake City Way NE Ste 310
Seattle, WA 98125-8631
Phone
(425) 954-6524
Fax
(206) 962-4999
NPI assigned
Apr 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X CH60539446 WA
Chiropractor 111N00000X CH60539446 WA Primary

Addresses

Primary practice location

13751 Lake City Way NE Ste 310
Seattle, WA 98125-8631

Mailing address

12311 32ND Ave NE Apt 409
Seattle, WA 98125-5599
Phone (206) 293-5508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818000375 WA Practitioner - Chiropractic 1052737343 Practice locations: Seattle, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13751 Lake City Way NE
Suite 310
Seattle, WA 98125-8631
Phone (425) 954-6524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60539446WAMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1730576794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 32ND AVE NE APT 409",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255599",
            "telephone_number": "206-293-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13751 LAKE CITY WAY NE STE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981258631",
            "telephone_number": "425-954-6524",
            "fax_number": "206-962-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "KIHYUK",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-16",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH60539446",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60539446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.