Active NPI
Jin Young Chung, D.O.
- Pediatrics Physician
- Lansing, MI
National Provider Identifier
1952582041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 5101016606
- Practice address
- 901 E Mount Hope Ave
Lansing, MI 48910-3207 - Phone
- (517) 267-3401
- NPI assigned
- Nov 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5101016606 | MI | Primary |
Addresses
Primary practice location
901 E Mount Hope Ave
Lansing, MI 48910-3207
Mailing address
425 Ryder Rd Apt 315
Lansing, MI 48917-1016
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5101016606 | Other | MI | EDUCATIONAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101016606 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195257600000",
"number": "1952582041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 RYDER RD APT 315",
"city": "LANSING",
"state": "MI",
"postal_code": "489171016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 E MOUNT HOPE AVE",
"city": "LANSING",
"state": "MI",
"postal_code": "489103207",
"telephone_number": "517-267-3401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "JIN",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-17",
"last_updated": "2007-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "5101016606",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATIONAL LICENSE",
"identifier": "5101016606",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.