Tae Hoon Ji, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1074 Issued in AZ

Practice address

1933 W Main St Ste 1
Mesa, AZ 85201-6930

Phone

(480) 730-4991

Fax

(480) 946-3366

NPI assigned

Jun 14, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891225595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 W MAIN ST STE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016930",
            "telephone_number": "480-730-4991",
            "fax_number": "480-946-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 W MAIN ST STE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016930",
            "telephone_number": "480-730-4991",
            "fax_number": "480-946-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 E Warner Rd # C2",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852844555",
            "country_code": "US",
            "telephone_number": "480-857-8911",
            "fax_number": "480-857-8920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JI",
        "first_name": "TAE",
        "middle_name": "HOON",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "1074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "283",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Matthias Jessop
• Rachell Marie Jewell
• Jeff H. Jex, D.C.
• Jfox II LLC
• Lokesh Kumar Jha, MD
• Mary Jiaocma
• Moh'D Jibreel, MD
• Paul Ace Jim III, LCSW
• Jonathan Jimenez Flores, DPT
• Jose Manuel Jimenez-Cintron, MD

• Acupuncturist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Acupuncturist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.