Individual provider Active NPI

Jeyoung Yun, D.C

  • Chiropractor
  • Woodbridge, VA
National Provider Identifier
1902870520
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556479 Issued in VA
Practice address
14416 Jefferson Davis Hwy Ste 12
Woodbridge, VA 22191-2890
Phone
(571) 572-3274
Fax
(571) 572-3278
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556479 VA Primary

Addresses

Primary practice location

14416 Jefferson Davis Hwy Ste 12
Woodbridge, VA 22191-2890

Mailing address

14416 Jefferson Davis Hwy Ste 12
Woodbridge, VA 22191-2890
Phone (571) 572-3274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000528 VA Practitioner - Chiropractic 1658395264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14904 Richmond Hwy
Suite 309
Woodbridge, VA 22191-3908
Phone (571) 572-3274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeyoung Yun DC LLC Chiropractor CurrentSince May 9, 2011 Accepting new patients
Benchley Chiropractic Clinic, P.C. Chiropractor PastSince Jan 1, 1998 Accepting new patients

Locations

14904 Richmond Hwy
Ste 309
Woodbridge, VA 22191
Phone (571) 572-3274

Organizations & group practices 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1902870520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14416 JEFFERSON DAVIS HWY STE 12",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912890",
            "telephone_number": "571-572-3274",
            "fax_number": "571-572-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14416 JEFFERSON DAVIS HWY STE 12",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912890",
            "telephone_number": "571-572-3274",
            "fax_number": "571-572-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUN",
        "first_name": "JEYOUNG",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.