Active NPI
Jin Baik Chung, MD
- Family Medicine Physician
- New Lebanon, OH
National Provider Identifier
1790726388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35.042055
- Practice address
- 220 E Main St
New Lebanon, OH 45345-1299 - Phone
- (937) 687-1331
- Fax
- (937) 687-3216
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35.042055 | OH | Primary |
Addresses
Primary practice location
220 E Main St
New Lebanon, OH 45345-1299
Mailing address
220 E Main St
New Lebanon, OH 45345-1299
Phone (937) 687-1331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0364056 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384300800000",
"number": "1790726388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 E MAIN ST",
"city": "NEW LEBANON",
"state": "OH",
"postal_code": "453451299",
"telephone_number": "937-687-1331",
"fax_number": "937-687-3216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 E MAIN ST",
"city": "NEW LEBANON",
"state": "OH",
"postal_code": "453451299",
"telephone_number": "937-687-1331",
"fax_number": "937-687-3216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "JIN",
"middle_name": "BAIK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2013-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35.042055",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0364056",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Lebanon, OH
- Butler County Community Health Consortium, Inc.
- Butler County Community Health Consortium, Inc.
- Butler County Community Health Consortium, Inc.
- Butler County Community Health Consortium, Inc.
- Priscilla Carlisle, RPH
- Jared Matthew Crawford
- Chelsea Morgan Dale
- Heather R Della Vedova, PHARMD
- Jeremy Denney, PTA
- Aubrey Paige Dwire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.