Active NPI
Chae Hyung Chung
- Pharmacist
- Ponte Vedra Beach, FL
National Provider Identifier
1962007815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS55677
- Practice address
- 152 Front St
Ponte Vedra Beach, FL 32082-3058 - Phone
- (904) 285-3634
- NPI assigned
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS55677 | FL | Primary |
Addresses
Primary practice location
152 Front St
Ponte Vedra Beach, FL 32082-3058
Mailing address
411 Willow Winds Pkwy
Saint Johns, FL 32259-7271
Phone (770) 596-9919
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS55677 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1962007815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 WILLOW WINDS PKWY",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322597271",
"telephone_number": "770-596-9919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 FRONT ST",
"city": "PONTE VEDRA BEACH",
"state": "FL",
"postal_code": "320823058",
"telephone_number": "904-285-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "CHAE",
"middle_name": "HYUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS55677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponte Vedra Beach, FL
- Stephanie Michelle Ceparano
- Adam I. Chaifetz, D.C.
- Charles Perniciaro MD PA (Neptune Beach Dermatology)
- Charles V Perniciaro, M.D., P.C., D/B/a Brunswick Dermatology Clinic (Brunswick Dermatology Clinic)
- Christian Counseling Associates of Jacksonville
- Lauren Church
- Jessica Marie Clark, APRN
- Mary Kenley Clark, LICSW
- Claudia Rojas-Baisden
- Brett Johnathan Clayton, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.