Individual provider Active NPI

Jessica Chung, DO

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1902509136
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO4116 Issued in NV
Practice address
1707 W Charleston Blvd Ste 100
Las Vegas, NV 89102-2352
Phone
(702) 676-3650
Fax
(702) 671-5198
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO4116 NV Primary

Addresses

Primary practice location

1707 W Charleston Blvd Ste 100
Las Vegas, NV 89102-2352

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (702) 780-2315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920002585 NV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8527412840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine Internal Medicine PastSince Apr 6, 2023 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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1902509136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-2315",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022352",
            "telephone_number": "702-676-3650",
            "fax_number": "702-671-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JESSICA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO4116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.