NPIMap

Organization Active NPI

Jeong Wellness Chiropractic, Inc.

Doing business as Jeong Wellness Chiropractic

  • Chiropractor
  • Ellicott City, MD
National Provider Identifier
1770838492
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03677 Issued in MD
Legal business name
JEONG WELLNESS CHIROPRACTIC, INC.
Doing business as
Jeong Wellness Chiropractic
Practice address
3459 Saint Johns LN Ste 2
Ellicott City, MD 21042-4025
Phone
(410) 461-5695
Fax
(410) 461-5496
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Dr. Wookeun Jeong, D.CNPI 1851401087
Title
Owner/Office Manager
Phone
(410) 461-5695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03677 MD Primary

Addresses

Primary practice location

3459 Saint Johns LN Ste 2
Ellicott City, MD 21042-4025

Mailing address

3459 St. Johns Lane Ste. 2
Ellicott City, MD 21042-4025
Phone (410) 461-5695

Other names 1

  • JEONG WELLNESS CHIROPRACTIC Doing business as

National Provider Directory

National Provider Directory

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": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1770838492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3459 ST. JOHNS LANE STE. 2",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424025",
            "telephone_number": "410-461-5695",
            "fax_number": "410-461-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 SAINT JOHNS LN STE 2",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424025",
            "telephone_number": "410-461-5695",
            "fax_number": "410-461-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEONG WELLNESS CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "JEONG",
        "authorized_official_first_name": "WOOKEUN",
        "authorized_official_title_or_position": "OWNER/OFFICE MANAGER",
        "authorized_official_telephone_number": "410-461-5695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEONG WELLNESS CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.

Verify at the official NPI Registry.