Active NPI
Je Un Yoo, L.AC,M.AC,DIP'L.AC
- Acupuncturist
- Annandale, VA
National Provider Identifier
1780825406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 0121000519
- Practice address
- 4208 Evergreen LN
Suite 224
Annandale, VA 22003-3235 - Phone
- (703) 642-3300
- NPI assigned
- Mar 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 0121000519 | VA | Primary |
| Acupuncturist | 171100000X | U01636 | MD |
Addresses
Primary practice location
4208 Evergreen LN
Suite 224
Annandale, VA 22003-3235
Mailing address
4208 Evergreen LN
Suite 224
Annandale, VA 22003-3235
Phone (703) 642-3300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U01636 | Other | MD | STATE OF MARYLAND BOARD OF ACUPUNCTURE |
| 108692 | Other | NCCAOM | |
| 0121000519 | Other | VA | COMMONWELTH OF VIRGINIA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U01636 | MD | MD | Acupuncturist |
| 0121000519 | VA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acupuncture Innaechun,Inc | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1780825406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4208 EVERGREEN LN",
"address_2": "SUITE 224",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220033235",
"telephone_number": "703-642-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4208 EVERGREEN LN",
"address_2": "SUITE 224",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220033235",
"telephone_number": "703-642-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "JE",
"middle_name": "UN",
"name_prefix": "Mr.",
"credential": "L.AC,M.AC,DIP'L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "VA",
"license": "0121000519",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MD",
"license": "U01636",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MARYLAND BOARD OF ACUPUNCTURE",
"identifier": "U01636",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCAOM",
"identifier": "108692",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWELTH OF VIRGINIA",
"identifier": "0121000519",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Annandale, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.