Individual provider Active NPI

Chaeyeun Jeon, L.AC

  • Acupuncturist
  • Fairfax, VA
National Provider Identifier
1871142075
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
0121000936 Issued in VA
Practice address
10301 Democracy LN Ste 110C
Fairfax, VA 22030-2545
Phone
(202) 743-4122
NPI assigned
Sep 10, 2019
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0121000936 VA Primary

Addresses

Primary practice location

10301 Democracy LN Ste 110C
Fairfax, VA 22030-2545

Mailing address

12148 Garden Grove Cir Unit 301
Fairfax, VA 22030-9017
Phone (703) 307-7740

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

LicenseStateTypeSpecialty
0121000936VAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Chae Acupuncture LLC CurrentSince Apr 6, 2025 Accepting new patients

Locations

10301 Democracy Ln
Ste 110C
Fairfax, VA 22030
Phone (202) 743-4122

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1871142075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12148 GARDEN GROVE CIR UNIT 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220309017",
            "telephone_number": "703-307-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 DEMOCRACY LN STE 110C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302545",
            "telephone_number": "202-743-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEON",
        "first_name": "CHAEYEUN",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.