Individual provider Active NPI

Eundae Shugg, DC

  • Chiropractor
  • Lutherville, MD
National Provider Identifier
1942722053
Registry record updated Dec 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03812 Issued in MD
Practice address
1407 York Rd Ste 302
Lutherville, MD 21093
Phone
(410) 583-5654
NPI assigned
Jul 10, 2017
Last updated
Dec 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03812 MD Primary

Addresses

Primary practice location

1407 York Rd Ste 302
Lutherville, MD 21093

Mailing address

1407 York Rd Ste 302
Lutherville, MD 21093-6054
Phone (410) 583-5654

Other practice location 1

1741 Dorsey Rd Ste 104
Hanover, MD 21076-1188
Phone (410) 774-9870

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123004103 MD Practitioner - Chiropractic 3577800929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wow Chiropractic Clinic, Inc CurrentSince Jan 2, 2019 Accepting new patients

Locations

1741 Dorsey Rd
Ste 104
Hanover, MD 21076
Phone (410) 774-9870

1407 York Rd
Ste 302
Lutherville Timonium, MD 21093
Phone (410) 337-5443

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, 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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734739200000",
    "number": "1942722053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 YORK RD STE 302",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936054",
            "telephone_number": "410-583-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 YORK RD STE 302",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "410-583-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1741 Dorsey Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "MD",
            "postal_code": "210761188",
            "country_code": "US",
            "telephone_number": "410-774-9870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUGG",
        "first_name": "EUNDAE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.