Jun Sang Park, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 009726 Issued in PA

Practice address

704 Dekalb Pike
Blue Bell, PA 19422-1214

Phone

(484) 965-9432

Fax

(610) 646-0707

NPI assigned

Nov 12, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Happy Chiropractic & Wellness Center LLC

  • Chiropractor
  • East Norriton, PA
  • NPI 1770121451
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1891022752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 DEKALB PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221214",
            "telephone_number": "484-965-9432",
            "fax_number": "610-646-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 DEKALB PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221214",
            "telephone_number": "484-965-9432",
            "fax_number": "610-646-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUN",
        "middle_name": "SANG",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC 009726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Shane Osterman Jr.
• Laura Lynn Otto, LMHC, LPC, NCC, CCMH
• Sara Nicole Pagliaro, DO
• Palmquest Inc.
• In Kook Park, DMD
• Stella Jaeyeun Park, O.D
• Aida Pasalic, DMD
• Dipti Patel
• Shreya Patel, CRNP
• Lydia Patselas, LPC

• Chiropractor in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.